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General NPI Number Information
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NPI Number | 1396367173
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Entity Type | Organization
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Legal Business Name | SPECIALIZED HEARING SOLUTIONS LLC
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 301 S WEBSTER ST
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City | TAYLORVILLE
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State | IL
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Zip | 62568-2150
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Country | US
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Telephone | 217-824-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 775 N 1350 EAST RD
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City | OWANECO
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State | IL
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Zip | 62555-5517
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Country | US
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Telephone | 217-820-3462
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTAL BAKER
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Credential | HIS, LPN
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Telephone | 217-820-3462
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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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