Organization
MODESTO HEARING AID CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERASA LEE DAFFRON HEARING AID DISPENSE (OWNER)
(209) 577-1014
Entity
Organization
Contact information
Practice address
611 SCENIC DR, MODESTO, CA 95350-6156
(209) 577-1014
(209) 577-8046
Mailing address
611 SCENIC DR, MODESTO, CA 95350-6156
(209) 577-1014
(209) 577-8046
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
HA5008
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0216438
—
CA
Enumeration date
04/08/2009
Last updated
04/08/2009
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