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General NPI Number Information
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NPI Number | 1528476595
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Entity Type | Organization
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Legal Business Name | TINNITUS CLINIC LLC
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 1290 E BROOMFIELD ST
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-4449
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Country | US
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Telephone | 989-773-7032
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Fax | 989-773-4267
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Provider Business Mailing Address
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Address Line | 1290 E BROOMFIELD ST
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-4449
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Country | US
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Telephone | 989-773-7032
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Fax | 989-773-4267
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Authorized Official
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Title or Position | OWNER
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Name | MR. PATRICK LYNN SMITH
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Credential |
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Telephone | 989-773-7032
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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 |
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License Number State | MI
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