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General NPI Number Information
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NPI Number | 1760296446
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Entity Type | Individual
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Provider Name | MARK LAFAVE HAD
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Gender | Male
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 111 S 24TH ST W UNIT 7
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City | BILLINGS
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State | MT
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Zip | 59102-5659
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Country | US
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Telephone | 406-248-1006
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Fax | 406-324-9222
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Provider Business Mailing Address
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Address Line | 2156 N HILL FIELD RD STE 3
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City | LAYTON
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State | UT
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Zip | 84041-4771
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Country | US
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Telephone | 801-203-4055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | HAD-HAD-LIC-1734
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License Number State | MT
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