Organization
HEARING LAB TECHNOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERARD RUTHERFORD (HEARING INSTRUMENT SPECIALIST)
(918) 914-1669
Entity
Organization
Contact information
Practice address
12905 E 96TH ST N, OWASSO, OK 74055-4719
(405) 308-4973
Mailing address
12905 E 96TH ST N, OWASSO, OK 74055-4719
(405) 308-4973
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
1039
OK
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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