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General NPI Number Information
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NPI Number | 1760553531
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Entity Type | Organization
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Legal Business Name | CHARLES A REGER & ASSOCIATES INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 425 PARK PLACE CIR SUITE 200
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City | MISHAWAKA
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State | IN
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Zip | 46545-3563
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Country | US
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Telephone | 574-243-7766
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Fax | 574-243-7796
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Provider Business Mailing Address
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Address Line | 425 PARK PLACE CIR SUITE 200
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City | MISHAWAKA
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State | IN
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Zip | 46545-3563
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Country | US
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Telephone | 574-243-7766
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Fax | 574-243-7796
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHARLES ALBERT REGER
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Credential | M.A.
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Telephone | 574-243-7766
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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 | 23001942
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License Number State | IN
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