Organization
MIRACLE EAR
Active
Organization
MIRACLE EAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN FAIRFIELD (HEARING AID SPECIALIST)
(805) 544-0592
Entity
Organization
Contact information
Practice address
297 SANTA ROSA ST STE B, SAN LUIS OBISPO, CA 93405-2498
(805) 544-0592
(805) 544-4642
Mailing address
297 SANTA ROSA ST STE B, SAN LUIS OBISPO, CA 93405-2498
(805) 544-0592
(805) 544-4642
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
040052
CA
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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