Basic Information
| Provider Information | |||||||||
| NPI: | 1275728669 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | C&C HEARING CLINICS, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MIRACLE-EAR | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3040 N COUNTRY CLUB RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857161603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203270882 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1424 SIDNEY BAKER ST | ||||||||
| Address2: | SUITE 1424 | ||||||||
| City: | KERRVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780282725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8307925955 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2007 | ||||||||
| LastUpdateDate: | 09/10/2007 | ||||||||
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| AuthorizedOfficialLastName: | CMIEL | ||||||||
| AuthorizedOfficialFirstName: | CANDICE | ||||||||
| AuthorizedOfficialMiddleName: | CATHERINE | ||||||||
| AuthorizedOfficialTitleorPosition: | PATIENT CARE COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 5203270882 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.