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NPI 1881722981

NPI 1881722981 : THE HEARING CLINIC, INC. : GRAND ISLAND, NE

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General NPI Number Information
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    NPI Number           |    1881722981
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    Entity Type          |    Organization 
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    Legal Business Name  |    THE HEARING CLINIC, INC. 
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Dates
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    Enumeration Date     |    03/01/2007
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    Last Update Date     |    06/29/2012
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Provider Practice Location Address
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    Address Line         |    2421 WEST FAIDLEY AVENUE 
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    City                 |    GRAND ISLAND
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    State                |    NE
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    Zip                  |    68803-4328
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    Country              |    US
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    Telephone            |    308-384-2101
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    Fax                  |    308-381-4787
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Provider Business Mailing Address
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    Address Line         |    2421 WEST FAIDLEY AVENUE 
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    City                 |    GRAND ISLAND
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    State                |    NE
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    Zip                  |    68803-4328
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    Country              |    US
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    Telephone            |    308-384-2101
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    Fax                  |    308-381-4787
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. CRAIG A FOSS 
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    Credential           |    AU.D F-AA
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    Telephone            |    308-384-2101
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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       |    64
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    License Number State |    NE
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Taxonomy #2
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    Taxonomy Code        |    237600000X
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    Taxonomy Name        |    Audiologist-Hearing Aid Fitter
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    License Number       |    020
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    License Number State |    NE
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Taxonomy #3
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    Taxonomy Code        |    237600000X
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    Taxonomy Name        |    Audiologist-Hearing Aid Fitter
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    License Number       |    
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    License Number State |    
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