Basic Information
| Provider Information | |||||||||
| NPI: | 1003056789 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | HARRY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 N HERRITAGE ST | ||||||||
| Address2: | |||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285011651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522855098 | ||||||||
| FaxNumber: | 5616888877 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 E WASHINGTON ST STE 1817 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606021807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6363976966 | ||||||||
| FaxNumber: | 6363976836 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2009 | ||||||||
| LastUpdateDate: | 04/25/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | MO | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | 1542 | NC | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.