Organization
PERRYSBURG HEARING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN LYNN JONES MILLER MA CCCA (AUDIOLOGIST)
(419) 873-1783
Entity
Organization
Contact information
Practice address
318 LOUISIANA AVE, PERRYSBURG, OH 43551-1461
(419) 873-1783
(419) 873-0693
Mailing address
318 LOUISIANA AVE, PERRYSBURG, OH 43551-1461
(419) 873-1783
(419) 873-0693
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A00661
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000330899
ANTHEM BCBS
OH
01
—
11570380
CAQH
—
05
—
2689434
—
OH
01
—
300705152001
MEDICAL MUTUAL
OH
Enumeration date
01/18/2007
Last updated
08/22/2020
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