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General NPI Number Information
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NPI Number | 1609901297
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Entity Type | Organization
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Legal Business Name | DEFIANCE HEARING AID CENTER, INC.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 836 E 2ND ST
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City | DEFIANCE
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State | OH
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Zip | 43512-2326
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Country | US
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Telephone | 419-782-0836
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Fax |
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Provider Business Mailing Address
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Address Line | 836 E 2ND ST
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City | DEFIANCE
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State | OH
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Zip | 43512-2326
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Country | US
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Telephone | 419-782-0836
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN STEVEN SAMUELSON
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Credential | BC-HIS
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Telephone | 419-782-0836
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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 | 2002
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License Number State | OH
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