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General NPI Number Information
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NPI Number | 1376041590
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Entity Type | Organization
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Legal Business Name | DOVER AUDIOLOGY, P.A.
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 859 W MAIN ST
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City | DOVER FOXCROFT
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State | ME
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Zip | 04426-1020
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Country | US
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Telephone | 207-564-3337
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Fax |
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Provider Business Mailing Address
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Address Line | 859 W MAIN ST
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City | DOVER FOXCROFT
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State | ME
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Zip | 04426-1020
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Country | US
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Telephone | 207-564-3337
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Fax |
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Authorized Official
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Title or Position | OWNVER
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Name | CHRIS ROBERT CLUKEY
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Credential | MA,CCC-A
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Telephone | 207-564-3337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AP1360
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License Number State | ME
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