Organization
MIRACLE EAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY V VOTAVA HIS (PRESIDENT)
(763) 421-1688
Entity
Organization
Contact information
Practice address
1611 W COUNTY RD B, SUITE 204, ROSEVILLE, MN 55113
(651) 631-9363
Mailing address
1611 COUNTY ROAD B W, SUITE #204, ROSEVILLE, MN 55113-5021
(657) 631-9363
(651) 639-0896
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
—
—
Other
Enumeration date
03/19/2008
Last updated
07/09/2009
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