Organization
PROFESSIONAL HEARING AID CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CAROL CAECILIA BLACK (OWNER/DISPENSER)
(423) 638-4158
Entity
Organization
Contact information
Practice address
705 PROFESSIONAL PLAZA, #3, GREENVILLE, TN 37745
(423) 638-4158
(423) 638-4158
Mailing address
705 PROFESSIONAL PLAZA, #3, GREENVILLE, TN 37745
(423) 638-4158
(423) 638-4158
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
0000515
TN
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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