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General NPI Number Information
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NPI Number | 1518407709
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Entity Type | Organization
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Legal Business Name | BRIGHT LIFE HEARING CARE, LLC
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 5931 W STATE ROAD 46
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City | BLOOMINGTON
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State | IN
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Zip | 47404-9359
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Country | US
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Telephone | 812-345-8608
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Fax |
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Provider Business Mailing Address
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Address Line | 5931 W STATE ROAD 46
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City | BLOOMINGTON
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State | IN
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Zip | 47404-9359
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Country | US
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Telephone | 812-345-8608
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. HEATHER LYNN WHITE
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Credential | AUD
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Telephone | 812-935-5305
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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 | 23002500A
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License Number State | IN
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