Individual
MR. FRED JOSEPH FAVETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., CCC-A
Contact information
Practice address
2400 TALLMADGE RD, RAVENNA, OH 44266-8218
(330) 678-4646
Mailing address
2400 TALLMADGE RD, RAVENNA, OH 44266-8218
(330) 678-4646
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
A-0429
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0643665
—
OH
Enumeration date
06/05/2007
Last updated
07/09/2007
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