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General NPI Number Information
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NPI Number | 1790227205
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Entity Type | Organization
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Legal Business Name | BELMONT HEARING CENTER LLC
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 100 N MAIN ST SUITE 123
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City | BELMONT
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State | NC
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Zip | 28012-3104
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Country | US
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Telephone | 704-860-7795
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Fax |
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Provider Business Mailing Address
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Address Line | 128 W NIMS AVE
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City | MT HOLLY
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State | NC
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Zip | 28120-1839
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Country | US
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Telephone | 239-292-2485
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. EDWARD EUGENE GRUBBS JR.
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Credential |
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Telephone | 239-292-2485
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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 | 1053
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License Number State | NC
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