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General NPI Number Information
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NPI Number | 1417439068
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Entity Type | Organization
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Legal Business Name | MARIS COMPANY, LLC
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 366 E GEORGE ST
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City | IVANHOE
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State | MN
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Zip | 56142-9711
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Country | US
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Telephone | 507-694-1416
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Fax | 507-694-1405
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Provider Business Mailing Address
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Address Line | 2744 220TH AVE
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City | IVANHOE
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State | MN
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Zip | 56142-4110
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Country | US
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Telephone | 507-694-1862
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Fax | 507-694-1405
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Authorized Official
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Title or Position | HEARING AID FITTER
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Name | MRS. MARILYN LUCY SCHROEDER
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Credential | HIS
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Telephone | 507-694-1862
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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 | 2668
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License Number State | MN
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