Provider Demographics
NPI:1073811543
Name:ADVANCED HEARING INC
Entity Type:Organization
Organization Name:ADVANCED HEARING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:OLIVE
Authorized Official - Last Name:ATTIAS MAGANA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:952-715-7033
Mailing Address - Street 1:1645 LYNDALE AVE. N
Mailing Address - Street 2:#103
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-2934
Mailing Address - Country:US
Mailing Address - Phone:507-412-0855
Mailing Address - Fax:
Practice Address - Street 1:1645 LYNDALE AVE N
Practice Address - Street 2:#103
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-2934
Practice Address - Country:US
Practice Address - Phone:507-412-0855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6170261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center