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General NPI Number Information
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NPI Number | 1356159628
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Entity Type | Organization
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Legal Business Name | NORTHLAND HEARING CENTERS INC
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 1712C E IRLO BRONSON MEMORIAL HWY STE C
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City | ST CLOUD
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State | FL
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Zip | 34771
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Country | US
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Telephone | 407-910-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 6700 WASHINGTON AVE S
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-3405
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Country | US
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Telephone | 800-328-8602
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | LORI MONSON
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Credential |
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Telephone | 952-941-6401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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