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General NPI Number Information
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NPI Number | 1861748626
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Entity Type | Organization
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Legal Business Name | CLEAR CHOICE HEARING AID CENTERS, LLC
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 638 WAGNER AVE
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City | GREENVILLE
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State | OH
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Zip | 45331-2649
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Country | US
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Telephone | 937-316-6689
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Fax | 937-316-6687
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Provider Business Mailing Address
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Address Line | 2901A E MAIN ST
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City | RICHMOND
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State | IN
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Zip | 47374-3545
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Country | US
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Telephone | 765-488-0859
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RYAN LEE ANDERSON
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Credential | HAD
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Telephone | 765-488-0859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 03058
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License Number State | OH
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