Basic Information
| Provider Information | |||||||||
| NPI: | 1952799751 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALLEN HEARING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 BEVILLE RD | ||||||||
| Address2: | SUITE 20 | ||||||||
| City: | DAYTONA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321199009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3868723661 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1301 BEVILLE RD | ||||||||
| Address2: | SUITE 20 | ||||||||
| City: | DAYTONA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321199009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3868723661 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2014 | ||||||||
| LastUpdateDate: | 12/31/2014 | ||||||||
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| AuthorizedOfficialLastName: | ALLEN | ||||||||
| AuthorizedOfficialFirstName: | DAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | HEARING AID SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 3868723661 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | BC, HIS, HAS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | AS 2459 | FL | Y | Suppliers | Hearing Aid Equipment |
No ID Information.