Basic Information
| Provider Information | |||||||||
| NPI: | 1659421451 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CROWE | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | W. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | H.I.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1153 NILES CORTLAND RD SE | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444842542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303730006 | ||||||||
| FaxNumber: | 3303730008 | ||||||||
| Practice Location | |||||||||
| Address1: | 1153 NILES CORTLAND RD SE | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444842542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303730006 | ||||||||
| FaxNumber: | 3303730008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2712 | OH | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.