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General NPI Number Information
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NPI Number | 1982852539
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Entity Type | Organization
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Legal Business Name | THE HEARING STORES OF MINNESOTA
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 12 E 66TH ST
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City | RICHFIELD
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State | MN
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Zip | 55423-2454
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Country | US
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Telephone | 952-223-4438
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Fax | 952-223-4438
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Provider Business Mailing Address
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Address Line | 12 E 66TH ST
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City | RICHFIELD
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State | MN
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Zip | 55423-2454
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Country | US
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Telephone | 952-223-4438
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Fax | 952-223-4438
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Authorized Official
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Title or Position | PRINCIPLE
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Name | MR. MATTHEW JAMES MATTIS
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Credential |
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Telephone | 952-334-8762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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