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General NPI Number Information
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NPI Number | 1417100710
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Entity Type | Organization
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Legal Business Name | QUEEN CITY EAR, NOSE & THROAT ASSOCIATES
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 11135 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45249-2338
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Country | US
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Telephone | 513-793-9600
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Fax | 513-793-4928
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Provider Business Mailing Address
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Address Line | 11135 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45249-2338
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Country | US
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Telephone | 513-793-9600
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Fax | 513-793-4928
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | JEANINE BRAILEY
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Credential | CMM
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Telephone | 513-793-9600
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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 | A01347
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License Number State | OH
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