| NPI | 1720687890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY RAISEN Physician 701-805-8057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter |
| Additional Taxonomies | 231H00000X Audiologist |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-12-10 |