Organization
ADVANCED AUDIOLOGY & HEARING CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY L CHASTAIN (OWNER/FOUNDER/SOLE MEMBER)
(812) 275-4479
Entity
Organization
Contact information
Practice address
3525 MITCHELL RD, BEDFORD, IN 47421-5558
(812) 275-4479
Mailing address
3525 MITCHELL RD, BEDFORD, IN 47421-5558
(812) 275-4479
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467428110
PERSONAL NPI
—
05
—
200028290
—
IN
01
—
23002103A
LICENSE
—
Enumeration date
10/08/2008
Last updated
12/09/2008
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