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General NPI Number Information
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NPI Number | 1932716073
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Entity Type | Organization
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Legal Business Name | MARTHAS VINEYARD HEARING CARE
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Dates
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Enumeration Date | 09/23/2020
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Last Update Date | 09/23/2020
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Provider Practice Location Address
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Address Line | 25 RIVER RD # A2
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City | MARSTONS MILLS
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State | MA
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Zip | 02648-1778
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Country | US
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Telephone | 720-289-7410
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2362
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City | HYANNIS
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State | MA
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Zip | 02601-7362
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Country | US
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Telephone | 720-289-7410
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. JAMIE GRACE LOSCHEN
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Credential | AUD
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Telephone | 720-289-7410
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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 |
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License Number State |
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