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General NPI Number Information
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NPI Number | 1659761062
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Entity Type | Organization
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Legal Business Name | APPALACHIAN HEARING AND SPEECH CENTER, LLC
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Dates
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Enumeration Date | 01/24/2015
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Last Update Date | 01/24/2015
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Provider Practice Location Address
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Address Line | 306 SUNSET DR SUITE 103
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2492
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Country | US
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Telephone | 423-328-9190
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Fax | 423-328-9189
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Provider Business Mailing Address
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Address Line | 306 SUNSET DR SUITE 103
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2492
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Country | US
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Telephone | 423-328-9190
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Fax | 423-328-9189
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | CHRISTOPHER A. BURKS
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Credential | AU. D.
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Telephone | 423-914-2846
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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 | 247
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1468
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License Number State | TN
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