Organization
NORTHLAND HEARING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES LEWIS LAYTART (CREDENTIALING SPECIALIST)
(952) 915-6248
Entity
Organization
Contact information
Practice address
18010 R PLZ STE 107, OMAHA, NE 68135-1923
(800) 328-8602
Mailing address
6700 WASHINGTON AVE S, EDEN PRAIRIE, MN 55344-3405
(612) 351-1529
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2018
Last updated
06/27/2019
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