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General NPI Number Information
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NPI Number | 1558703512
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HEARING CARE, LLC
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 509 N UNION ST
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City | MAUSTON
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State | WI
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Zip | 53948-1148
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Country | US
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Telephone | 608-847-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 509 N UNION ST
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City | MAUSTON
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State | WI
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Zip | 53948-1148
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Country | US
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Telephone | 608-847-2444
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Fax |
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Authorized Official
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Title or Position | OWNER/AUDIOLOGIST
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Name | DR. ANN LYNN RAABE
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Credential | AU.D.
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Telephone | 608-847-2444
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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 | 104-156
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License Number State | WI
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