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General NPI Number Information
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NPI Number | 1518383553
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Entity Type | Organization
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Legal Business Name | EAGLE HEARING LLC
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Dates
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Enumeration Date | 03/14/2014
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 440 E STATE ST STE 100
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City | EAGLE
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State | ID
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Zip | 83616-5935
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Country | US
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Telephone | 319-610-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 440 E STATE ST STE 100
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City | EAGLE
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State | ID
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Zip | 83616-5935
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Country | US
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Telephone | 319-610-8111
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. ABRAM VORE
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Credential |
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Telephone | 319-610-8111
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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 | AUD-2414
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License Number State | ID
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