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General NPI Number Information
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NPI Number | 1417210725
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Entity Type | Organization
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Legal Business Name | CARROLL HEARING ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 333 WHITESPORT DR SW SUITE 302
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6454
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Country | US
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Telephone | 256-489-9992
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Fax |
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Provider Business Mailing Address
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Address Line | 333 WHITESPORT DR SW SUITE 302
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6454
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Country | US
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Telephone | 256-489-9992
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST-OWNER
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Name | MARK R CARROLL
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Credential | M.S., CCC-A
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Telephone | 256-489-9992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 579A
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License Number State | AL
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