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General NPI Number Information
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NPI Number | 1598966434
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Entity Type | Organization
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Legal Business Name | LIFESTYLE HEARING AID SOLUTIONS INC.
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 1965 FOOTHILL BLVD STE R
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City | LA VERNE
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State | CA
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Zip | 91750-3502
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Country | US
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Telephone | 909-593-0550
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Fax | 909-593-0551
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Provider Business Mailing Address
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Address Line | 1965 FOOTHILL BLVD SUITE R
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City | LA VERNE
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State | CA
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Zip | 91750-3502
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Country | US
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Telephone | 909-593-0550
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Fax | 909-593-0551
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY T NUGENT
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Credential |
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Telephone | 909-593-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA-6009
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License Number State | CA
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