Individual
ANNA MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
200 S JORDAN AVE, BLOOMINGTON, IN 47405-7002
(812) 855-7439
Mailing address
200 S JORDAN AVE, BLOOMINGTON, IN 47405-7002
(812) 855-7439
(812) 855-5561
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002514A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201233990
—
IN
Enumeration date
06/27/2014
Last updated
07/14/2016
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