Organization
HEARCARE PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH STEWART (OWNER)
(260) 485-1231
Entity
Organization
Contact information
Practice address
3030 LAKE AVE STE 23, FORT WAYNE, IN 46805-5428
(260) 485-1231
(260) 486-6958
Mailing address
3030 LAKE AVE STE 23, FORT WAYNE, IN 46805-5428
(260) 485-1231
(260) 486-6958
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
58000024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200307600
—
IN
Enumeration date
03/13/2007
Last updated
09/14/2018
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