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General NPI Number Information
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NPI Number | 1477937019
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HEARING SERVICES, INC.
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 1500 CENTER ST NE STE 102
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-5500
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Country | US
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Telephone | 319-393-4673
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Fax | 319-200-4068
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Provider Business Mailing Address
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Address Line | 1500 CENTER ST NE STE 102
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-5500
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Country | US
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Telephone | 319-393-4673
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Fax | 319-200-4068
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. JILL LYNNETTE NESHAM
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Credential | AU.D.
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Telephone | 319-393-4673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 00533
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License Number State | IA
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