Basic Information
| Provider Information | |||||||||
| NPI: | 1033746151 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREER | ||||||||
| FirstName: | IAN | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8410 S 73RD PLZ STE 111 | ||||||||
| Address2: | |||||||||
| City: | PAPILLION | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680461514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023316305 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8410 S 73RD PLZ STE 111 | ||||||||
| Address2: | |||||||||
| City: | PAPILLION | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680461514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023316305 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2020 | ||||||||
| LastUpdateDate: | 03/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 843 | NE | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.