| NPI | 1770776817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MADDOCK Owner 910-791-4755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 1790) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: NC 1790) |
| 231HA2500X Audiologist, Assistive Technology Supplier (Licence: NC 1790) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NC 1790) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2012-10-29 |