Organization
HOMETOWN HEARING CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY O OTWELL AU.D. (OWNER)
(850) 625-3796
Entity
Organization
Contact information
Practice address
4297 3RD AVE, MARIANNA, FL 32446-2136
(850) 625-3796
Mailing address
4297 3RD AVE, MARIANNA, FL 32446-2136
(850) 625-3796
Taxonomy
Speciality
Code
Description
License number
State
231HA2400X
Assistive Technology Practitioner Audiologist
Primary
AY370
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600237400
—
FL
Enumeration date
04/18/2018
Last updated
04/18/2018
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