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General NPI Number Information
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NPI Number | 1558590265
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Entity Type | Organization
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Legal Business Name | MUTTER'S PRECISION HEARING CENTER, INC
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 07/02/2009
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Provider Practice Location Address
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Address Line | 1680 SW SAINT LUCIE WEST BLVD SUITE 103
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-1927
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Country | US
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Telephone | 772-871-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 1680 SW SAINT LUCIE WEST BLVD SUITE 103
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-1927
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Country | US
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Telephone | 772-871-1222
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. JOSEPH BOYD MUTTER
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Credential | H.A.S.
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Telephone | 772-871-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | AS3398
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License Number State | FL
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