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General NPI Number Information
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NPI Number | 1558535716
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Entity Type | Individual
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Provider Name | CHARLES E KIMPLE MA
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Gender | Male
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 3211 LIBERTY ST LL1
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City | ERIE
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State | PA
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Zip | 16508-2575
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Country | US
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Telephone | 814-868-1990
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Fax | 814-866-0853
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Provider Business Mailing Address
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Address Line | 3211 LIBERTY ST LL1
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City | ERIE
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State | PA
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Zip | 16508-2575
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Country | US
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Telephone | 814-868-1990
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Fax | 814-866-0853
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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 | AT000544L
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License Number State | PA
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