| NPI | 1942501325 |
|---|---|
| Doing Business As | PORTRAIT HEALTH CENTERS OF BUFFALO GROVE AUDIOLOGY |
| Entity Type | Organization |
| Authorized Contact | MICHELLE MELISSA MATTINGLY President 847-868-3435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: IL 147-000978) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |