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Organization

FAIRBORN HEARING AID CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CLYDE L REDD JR. BC-HIS (OWNER)
(937) 879-1842
Entity
Organization

Contact information

Practice address
331 N BROAD ST, FAIRBORN, OH 45324-4934
(937) 879-1842
Mailing address
331 N BROAD ST, FAIRBORN, OH 45324-4934
(937) 879-1842

Taxonomy

Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
1918
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0887063
OH
Enumeration date
10/18/2007
Last updated
10/18/2007
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