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General NPI Number Information
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NPI Number | 1578751558
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Entity Type | Organization
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Legal Business Name | AMERICAN EAR HEARING & AUDIOLOGY, LLC
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 905 N. 21ST STREET
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City | NEWARK
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State | OH
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Zip | 43055
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Country | US
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Telephone | 740-344-4412
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Fax | 740-364-0199
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Provider Business Mailing Address
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Address Line | 905 N. 21ST STREET
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City | NEWARK
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State | OH
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Zip | 43055
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Country | US
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Telephone | 740-344-4412
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Fax | 740-364-0199
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Authorized Official
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Title or Position | CORPORATE MANAGER
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Name | DELTA LEE SIRLES
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Credential |
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Telephone | 740-344-4412
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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 | CERT. # 007310
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License Number State | OH
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