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General NPI Number Information
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NPI Number | 1447549969
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Entity Type | Organization
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Legal Business Name | ARDMORE HEARING AID SERVICE, INC
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 903 GRAND AVE
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City | ARDMORE
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State | OK
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Zip | 73401-4338
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Country | US
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Telephone | 580-223-7771
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1852
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City | ARDMORE
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State | OK
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Zip | 73402-1852
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JOHN MARSHALL
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Credential |
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Telephone | 580-223-7771
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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 | 1062
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License Number State | OK
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