Provider Demographics
NPI:1164904793
Name:LITTLE FALLS HEARING CLINIC, LLC
Entity Type:Organization
Organization Name:LITTLE FALLS HEARING CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN STONE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:320-616-6850
Mailing Address - Street 1:109 5TH ST NE STE 2
Mailing Address - Street 2:PO BOX 393
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345
Mailing Address - Country:US
Mailing Address - Phone:320-616-6850
Mailing Address - Fax:
Practice Address - Street 1:109 5TH ST NE STE 2
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-2732
Practice Address - Country:US
Practice Address - Phone:320-616-6850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8930231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty