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General NPI Number Information
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NPI Number | 1780220392
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Entity Type | Organization
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Legal Business Name | BLOSSOM HEARING HEALTH, LLC
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Dates
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Enumeration Date | 11/19/2019
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 8805 BLOSSOM CIR NW
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City | MASSILLON
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State | OH
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Zip | 44646-1346
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Country | US
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Telephone | 330-327-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 8805 BLOSSOM CIR NW
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City | MASSILLON
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State | OH
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Zip | 44646-1346
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Country | US
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Telephone | 330-327-1335
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Fax |
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Authorized Official
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Title or Position | OWNER/AUDIOLOGIST
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Name | KELLY MARIE BYRER
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Credential | AU.D.
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Telephone | 330-354-1968
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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 |
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License Number State |
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