Provider Demographics
NPI:1417622234
Name:GANT HEARING CARE
Entity Type:Organization
Organization Name:GANT HEARING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:O
Authorized Official - Last Name:GANT
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:828-734-5855
Mailing Address - Street 1:761 PETERS COVE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-6594
Mailing Address - Country:US
Mailing Address - Phone:828-734-5855
Mailing Address - Fax:
Practice Address - Street 1:69 WESTRIDGE MARKET PL
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9174
Practice Address - Country:US
Practice Address - Phone:828-734-5855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1780634519Medicaid