Provider Demographics
NPI:1306190483
Name:HENRY HEARING
Entity Type:Organization
Organization Name:HENRY HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARTHA
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:501-837-3337
Mailing Address - Street 1:1412 MELLON ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6150
Mailing Address - Country:US
Mailing Address - Phone:501-837-3337
Mailing Address - Fax:
Practice Address - Street 1:1412 MELLON ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6150
Practice Address - Country:US
Practice Address - Phone:501-837-3337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA214261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech