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General NPI Number Information
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NPI Number | 1790816924
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Entity Type | Organization
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Legal Business Name | BREVARD HEARING CENTER, LLC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 127 N BROAD ST STE C
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City | BREVARD
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State | NC
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Zip | 28712-3358
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Country | US
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Telephone | 828-966-4327
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Fax | 828-966-4352
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Provider Business Mailing Address
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Address Line | PO BOX 946
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City | BREVARD
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State | NC
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Zip | 28712-0946
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Country | US
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Telephone | 828-966-4327
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Fax | 828-966-4352
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | MRS. JUDITH C WELCH
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Credential | AUD
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Telephone | 828-966-4327
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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 | 711
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License Number State | NC
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