| NPI | 1528225596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA BROADDUS Owner 815-787-4237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech (Licence: IL 147-000688) |
| Additional Taxonomies | 332S00000X Hearing Aid Equipment (Licence: IL 147-000688) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |