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General NPI Number Information
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NPI Number | 1972772200
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Entity Type | Individual
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Provider Name | C. LEWIS ADDISON CCC-A, FAAA
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Gender | Male
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 3310 ALTA VISTA DR HEARTECH, LLC
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City | CHATTANOOGA
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State | TN
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Zip | 37411-4201
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Country | US
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Telephone | 423-785-7803
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 ALTA VISTA DR HEARTECH, LLC
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City | CHATTANOOGA
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State | TN
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Zip | 37411-4201
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Country | US
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Telephone | 423-785-7803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | A 0000000082
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License Number State | TN
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