Provider Demographics
NPI:1104191360
Name:HEARING ASSOCIATES INC
Entity Type:Organization
Organization Name:HEARING ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:218-723-7880
Mailing Address - Street 1:303 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3601
Mailing Address - Country:US
Mailing Address - Phone:218-326-6018
Mailing Address - Fax:218-326-5526
Practice Address - Street 1:4905 MATTERHORN DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3851
Practice Address - Country:US
Practice Address - Phone:218-723-7880
Practice Address - Fax:218-723-8208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARING ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5119231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03053OtherMEDICARE PTAN