=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972710531
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | D EVELYN JONES LICENSED HEARING AID
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2007
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2412 WEST STATE ST
-----------------------------------------------------
City | ALLIANCE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-821-3277
-----------------------------------------------------
Fax | 330-821-7760
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2412 WEST STATE ST
-----------------------------------------------------
City | ALLIANCE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-821-3277
-----------------------------------------------------
Fax | 330-821-7760
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237600000X
-----------------------------------------------------
Taxonomy Name | Audiologist-Hearing Aid Fitter
-----------------------------------------------------
License Number | 2198
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------