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General NPI Number Information
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NPI Number | 1699105486
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Entity Type | Organization
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Legal Business Name | STANDANI, LLC
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 603 S PALESTINE ST
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City | ATHENS
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State | TX
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Zip | 75751-3322
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Country | US
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Telephone | 903-670-1290
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Fax |
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Provider Business Mailing Address
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Address Line | 603 S PALESTINE ST
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City | ATHENS
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State | TX
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Zip | 75751-3322
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Country | US
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Telephone | 903-670-1290
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Fax |
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Authorized Official
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Title or Position | HEARING AID FITTER AND DISPENSER
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Name | MRS. CINDY D STANFORD
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Credential | LICENSED PRACTITIONE
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Telephone | 903-670-1290
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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 |
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License Number State |
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