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General NPI Number Information
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NPI Number | 1356678973
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Entity Type | Organization
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Legal Business Name | MID-STATES HEARING AID CENTER
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 417 10TH AVE
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City | CORALVILLE
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State | IA
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Zip | 52241-2373
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Country | US
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Telephone | 319-338-0211
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Fax |
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Provider Business Mailing Address
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Address Line | 417 10TH AVE
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City | CORALVILLE
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State | IA
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Zip | 52241-2373
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Country | US
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Telephone | 319-338-0211
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Fax |
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Authorized Official
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Title or Position | HEARING AID SPECIALIST, OWNER
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Name | MR. WILLIAM DEAN REINDL
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Credential | HAD
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Telephone | 319-338-0211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 313
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License Number State | IA
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