| NPI | 1164527628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA BOURNE President 276-322-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech (Licence: VA 2202001125) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |