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General NPI Number Information
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NPI Number | 1992802110
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN HEARING SERVICES, INC.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2308B 6TH ST
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City | TUSCALOOSA
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State | AL
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Zip | 35401-1741
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Country | US
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Telephone | 205-391-9876
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Fax | 205-391-9893
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Provider Business Mailing Address
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Address Line | 2308B 6TH ST
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City | TUSCALOOSA
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State | AL
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Zip | 35401-1741
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. AMANDA D NICHOLS
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Credential |
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Telephone | 205-391-9876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 817A
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License Number State | AL
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