Organization
COWETA HEARING CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIKKI D WEAVER (OWNER)
(770) 254-2224
Entity
Organization
Contact information
Practice address
2301 NEWNAN CROSSING BLVD E STE 160, NEWNAN, GA 30265-2576
(770) 254-2224
(770) 254-2225
Mailing address
2301 NEWNAN CROSSING BLVD E STE 160, NEWNAN, GA 30265-2576
(770) 254-2224
(770) 254-2225
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD003619
GA
261QH0700X
Hearing and Speech Clinic/Center
—
—
332S00000X
Hearing Aid Equipment
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216785196A
—
GA
Enumeration date
05/23/2007
Last updated
12/17/2020
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