Organization
SWEETIE PEETIE LLC
Active
Other names
Flagler Hearing
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIRGIL WAYNE BAKER BC-HIS (OWNER)
(904) 553-8033
Entity
Organization
Contact information
Practice address
4750 E. MOODY BLVD, SUITE # 105, BUNNELL, FL 32110-7710
(386) 263-2833
(386) 313-5134
Mailing address
4750 E. MOODY BLVD, SUITE # 105, BUNNELL, FL 32110-7710
(386) 263-2833
(386) 313-5134
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS2907
FL
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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