| NPI | 1790919496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERAH WAGNER Owner 317-443-0043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IN 17001256A) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: IN 17001256A) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2009-05-11 |