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Individual

PEGGY JO FRANK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA CCC-A

Contact information

Practice address
322 S. LAFAYETTE STREET, SUITE D, GREENVILLE, MI 48838
(616) 225-9892
(616) 225-9892
Mailing address
322 S. LAFAYETTE STREET, SUITE D, GREENVILLE, MI 48838
(616) 225-9892
(616) 225-9892

Taxonomy

Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
3501002249
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
540D113710
BCBS HEARING AID DEALER
MI
01
640D113770
BCBS AUDIOLOGY GROUP
MI
01
640D113780
BCBS AUDIOLOGY INDIVIDUAL
MI
05
804675488
MI
05
903471250
MI
Enumeration date
10/12/2005
Last updated
09/19/2013
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