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General NPI Number Information
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NPI Number | 1750753521
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERM HEARING CENTER, INC
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 4354 FAYETTEVILLE RD
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City | LUMBERTON
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State | NC
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Zip | 28358-2677
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Country | US
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Telephone | 910-671-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 4354 FAYETTEVILLE RD
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City | LUMBERTON
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State | NC
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Zip | 28358-2677
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Country | US
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Telephone | 910-671-1919
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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. JAMES PATRICK LITTLE JR.
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Credential | HIS
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Telephone | 910-671-1919
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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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