Organization
TIDEWATER HEARING CENTER
Active
Other names
Miracle Ear
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET IVENS (OWNER)
(757) 687-6643
Entity
Organization
Contact information
Practice address
4588 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23462-3004
(757) 687-6643
Mailing address
2555 COVE POINT PL, VIRGINIA BEACH, VA 23454-3271
(757) 687-6643
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
14763800005200
VA
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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