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General NPI Number Information
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NPI Number | 1881136844
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Entity Type | Organization
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Legal Business Name | FAMILY HEARING CENTER OF IDAHO, LLC
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 503 W APPLEWAY AVE STE P
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City | COEUR D ALENE
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State | ID
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Zip | 83814-8303
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Country | US
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Telephone | 208-667-6290
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Fax | 208-667-0911
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Provider Business Mailing Address
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Address Line | 503 W APPLEWAY AVE STE P
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City | COEUR D ALENE
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State | ID
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Zip | 83814-8303
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Country | US
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Telephone | 208-667-6290
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Fax | 208-667-0911
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Authorized Official
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Title or Position | MANAGER
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Name | DOUGLAS RAY WILLIAMS
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Credential |
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Telephone | 208-667-6290
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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 |
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License Number State | ID
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