Organization
MIRACLE EAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY V VOTAVA (PRESIDENT)
(763) 421-1688
Entity
Organization
Contact information
Practice address
12737 RIVERDALE BLVD NW, COON RAPIDS, MN 55448-1253
(763) 421-1688
(763) 421-1788
Mailing address
12737 RIVERDALE BLVD NW, COON RAPIDS, MN 55448-1253
(763) 421-1688
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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