Organization
BENNEBEL LLC
Active
Other names
Miracle Ear Center
Organization subpart
No
Provider details
NPI number
Authorized official
GREGG OLSEN (CO-OWNER)
(208) 957-6418
Entity
Organization
Contact information
Practice address
1059 E IRON EAGLE DR, EAGLE, ID 83616-6855
(208) 957-6418
(360) 573-4990
Mailing address
1059 E IRON EAGLE DR, SUITE 175, EAGLE, ID 83616-6855
(208) 957-6418
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1106
ID
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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