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General NPI Number Information
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NPI Number | 1356030076
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Entity Type | Organization
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Legal Business Name | QUALITY HEARING INDIANA LLC
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 642 N MADISON ST
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City | BLOOMINGTON
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State | IN
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Zip | 47404-4095
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Country | US
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Telephone | 317-813-9636
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Fax |
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Provider Business Mailing Address
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Address Line | 2815 E 3RD ST # 1073
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5434
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | MS. CONSUELO AYALA
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Credential |
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Telephone | 713-252-4932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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