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General NPI Number Information
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NPI Number | 1881971372
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Entity Type | Organization
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Legal Business Name | ANGEL EARS HEARING, INC
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 2600 LAKEWOOD VILLAGE PL STE D
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-8034
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Country | US
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Telephone | 615-957-4734
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 LAKEWOOD VILLAGE PL STE D
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-8034
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Country | US
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Telephone | 615-957-4734
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINDA MARIE BLOOMFIELD
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Credential | BC-HIS
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Telephone | 615-957-4734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 601AR
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License Number State | AR
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