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General NPI Number Information
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NPI Number | 1356670582
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Entity Type | Organization
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Legal Business Name | SOONER HEARING AIDS, LLC
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 900 17TH ST SPECIALTY CLINIC, 2ND FLOOR
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City | WOODWARD
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State | OK
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Zip | 73801-2448
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Country | US
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Telephone | 580-701-6425
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Fax | 580-701-6425
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Provider Business Mailing Address
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Address Line | 1316 NW SHERIDAN RD PNB 151
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City | LAWTON
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State | OK
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Zip | 73505-5212
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Country | US
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Telephone | 580-701-6425
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Fax | 580-701-6425
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Authorized Official
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Title or Position | MANAGER, HEARING INSTRUMENT SPECIAL
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Name | MRS. ALEXIS J.D. KAISER
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Credential | HEARING INSTRUMENT S
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Telephone | 860-946-7079
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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 | TEMP PERMIT
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 404
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License Number State | CT
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