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General NPI Number Information
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NPI Number | 1750532719
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Entity Type | Organization
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Legal Business Name | ADVANCED AUDIOLOGY & HEARING CARE, LLC
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 3525 MITCHELL RD
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City | BEDFORD
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State | IN
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Zip | 47421-5558
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Country | US
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Telephone | 812-275-4479
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Fax |
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Provider Business Mailing Address
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Address Line | 3525 MITCHELL RD
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City | BEDFORD
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State | IN
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Zip | 47421-5558
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Country | US
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Telephone | 812-275-4479
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER/SOLE MEMBER
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Name | KELLY L CHASTAIN
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Credential |
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Telephone | 812-275-4479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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