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General NPI Number Information
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NPI Number | 1417145640
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Entity Type | Organization
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Legal Business Name | POTTER'S HEARING AID SERVICE
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1416 W 4TH ST
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City | WATERLOO
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State | IA
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Zip | 50702-2908
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Country | US
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Telephone | 319-232-7113
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Fax | 319-232-6843
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Provider Business Mailing Address
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Address Line | 1416 W 4TH ST
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City | WATERLOO
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State | IA
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Zip | 50702-2908
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Country | US
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Telephone | 319-232-7113
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Fax | 319-232-6843
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Authorized Official
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Title or Position | HEARING AID SPECIALIST
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Name | DEBRA S KLOSTER
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Credential |
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Telephone | 319-232-7113
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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 |
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License Number State | IA
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