Provider Demographics
NPI:1255850418
Name:LEGACY HEARING INCORPORATED
Entity Type:Organization
Organization Name:LEGACY HEARING INCORPORATED
Other - Org Name:LOWRY HEARING AID CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:BRODY
Authorized Official - Last Name:RINK
Authorized Official - Suffix:
Authorized Official - Credentials:AAS-HIS
Authorized Official - Phone:417-553-0724
Mailing Address - Street 1:2640 E 32ND ST STE 11
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4311
Mailing Address - Country:US
Mailing Address - Phone:417-553-0724
Mailing Address - Fax:417-553-3478
Practice Address - Street 1:2640 E 32ND ST STE 11
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4311
Practice Address - Country:US
Practice Address - Phone:417-553-0724
Practice Address - Fax:417-553-3478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015039402237700000X
OK001105237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty