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General NPI Number Information
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NPI Number | 1760625651
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Entity Type | Organization
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Legal Business Name | MICHIGAN AUDIOLOGY & HEARING CENTER, PLLC
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 35054 23 MILE RD BLDG. B., SUITE 104
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City | NEW BALTIMORE
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State | MI
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Zip | 48047-2019
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Country | US
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Telephone | 586-716-0500
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Fax | 586-716-0789
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Provider Business Mailing Address
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Address Line | 35054 23 MILE RD BLDG. B., SUITE 104
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City | NEW BALTIMORE
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State | MI
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Zip | 48047-2019
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Country | US
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Telephone | 586-716-0500
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Fax | 586-716-0789
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER
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Name | MR. THOMAS C. GERBINO
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Credential | M.A.
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Telephone | 586-716-0500
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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 | 1601000037
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License Number State | MI
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