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General NPI Number Information
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NPI Number | 1528060761
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Entity Type | Individual
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Provider Name | CAROL A CHINN AUD
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Gender | Female
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 1501 SE WALTON BLVD STE 119
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City | BENTONVILLE
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State | AR
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Zip | 72712-3746
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Country | US
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Telephone | 479-254-0011
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Fax | 479-254-0710
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Provider Business Mailing Address
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Address Line | 1501 SE WALTON BLVD STE 119
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City | BENTONVILLE
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State | AR
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Zip | 72712-3746
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Country | US
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Telephone | 479-254-0011
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Fax | 479-254-0710
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | A-170
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License Number State | AR
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