Provider Demographics
NPI:1164877072
Name:MIDWEST HEARING CLINIC, P.C.
Entity Type:Organization
Organization Name:MIDWEST HEARING CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:712-580-4327
Mailing Address - Street 1:526 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-3912
Mailing Address - Country:US
Mailing Address - Phone:712-363-2254
Mailing Address - Fax:712-580-4329
Practice Address - Street 1:526 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-3912
Practice Address - Country:US
Practice Address - Phone:712-363-2254
Practice Address - Fax:712-580-4329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00480332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment