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General NPI Number Information
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NPI Number | 1710136213
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Entity Type | Organization
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Legal Business Name | DELTA HEARING SERVICES
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 2359 HIGHWAY 1 S
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City | GREENVILLE
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State | MS
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Zip | 38701-8337
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Country | US
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Telephone | 662-335-9434
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Fax |
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Provider Business Mailing Address
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Address Line | 2359 HIGHWAY 1 S
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City | GREENVILLE
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State | MS
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Zip | 38701-8337
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Country | US
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Telephone | 662-335-9434
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | ROBERT S MOORE
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Credential | M.A.CCC-A
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Telephone | 662-335-9434
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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 | A2092
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License Number State | MS
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