MEDICARE: MRS. TERRY DEANN HANKS H.I.S.

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	237700000X	Hearing Instrument Specialist	521	AR

General Provider Information

NPI Number	:	1932357308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERRY DEANN HANKS H.I.S.

Provider Business Mailing Address
First Line	:	101 PLAZA CARMONA PL STE A
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-3056
Country	:	US
Telephone Number	:	501-922-5600
Fax Number	:	501-922-5619

Provider Business Practice Location Address
First Line	:	101 PLAZA CARMONA PL STE A
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-3056
Country	:	US
Telephone Number	:	501-922-5600
Fax Number	:	501-922-5619

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2008
Last Update Date	:	08/28/2008

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