MEDICARE: FAMILY HEARING PROFESSIONALS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist

General Provider Information

NPI Number	:	1508200841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HEARING PROFESSIONALS

Provider Business Mailing Address
First Line	:	795 SUNSET BLVD
Second Line	:	STE B
City	:	KALISPELL
State	:	MT
Zip	:	59901-3699
Country	:	US
Telephone Number	:	406-257-4327
Fax Number	:	406-257-4395

Provider Business Practice Location Address
First Line	:	795 SUNSET BLVD
Second Line	:	STE B
City	:	KALISPELL
State	:	MT
Zip	:	59901-3699
Country	:	US
Telephone Number	:	406-257-4327
Fax Number	:	406-257-4395

Authorized Official
Title or Position	:	OWNER
Name	:	CARL H CLARK
Credential	:
Telephone Number	:	406-257-4327

Provider Enumeration Date	:	04/17/2013
Last Update Date	:	04/17/2013

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Directions to “FAMILY HEARING PROFESSIONALS ” Practice Location

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