MEDICARE: WOOSTER ENT ASSOC

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	237600000X	Audiologist-Hearing Aid Fitter	A01074	OH

General Provider Information

NPI Number	:	1528146578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOOSTER ENT ASSOC

Provider Business Mailing Address
First Line	:	14136 GALEHOUSE RD
Second Line	:
City	:	DOYLESTOWN
State	:	OH
Zip	:	44230
Country	:	US
Telephone Number	:	330-658-3104
Fax Number	:

Provider Business Practice Location Address
First Line	:	1749 CLEVELAND RD
Second Line	:	WOOSTER ENT
City	:	WOOSTER
State	:	OH
Zip	:	44691
Country	:	US
Telephone Number	:	330-264-9699
Fax Number	:	330-264-9644

Authorized Official
Title or Position	:	OFFICE MGR
Name	:	FRANCES M BEAN
Credential	:
Telephone Number	:	330-264-9699

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/22/2020

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Directions to “WOOSTER ENT ASSOC ” Practice Location

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