Provider Demographics
NPI:1093071888
Name:LUCHT, JEROME CHARLES (HEARING AID FITTER)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:CHARLES
Last Name:LUCHT
Suffix:
Gender:M
Credentials:HEARING AID FITTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N SHAMOKIN ST
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN
Mailing Address - State:PA
Mailing Address - Zip Code:17872-6718
Mailing Address - Country:US
Mailing Address - Phone:570-644-1603
Mailing Address - Fax:
Practice Address - Street 1:510 N SHAMOKIN ST
Practice Address - Street 2:
Practice Address - City:SHAMOKIN
Practice Address - State:PA
Practice Address - Zip Code:17872-6718
Practice Address - Country:US
Practice Address - Phone:570-644-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO3305237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist