=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578801239
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GROWTH FACTOR CONSULTING INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2013
-----------------------------------------------------
Last Update Date | 01/30/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24427 S 197TH PL
-----------------------------------------------------
City | QUEEN CREEK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85142-5012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-636-9792
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24427 S 197TH PL
-----------------------------------------------------
City | QUEEN CREEK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85142-5012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-636-9792
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PATRICIA ERICKSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 480-636-9792
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332S00000X
-----------------------------------------------------
Taxonomy Name | Hearing Aid Equipment
-----------------------------------------------------
License Number | THAD6856
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------