Provider Demographics
NPI:1437476926
Name:MOTT CHILDREN'S HEALTH CENTER-AUDIOLOGY
Entity Type:Organization
Organization Name:MOTT CHILDREN'S HEALTH CENTER-AUDIOLOGY
Other - Org Name:AUDIOLOGY DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT, FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:PASCOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-237-7570
Mailing Address - Street 1:806 TUURI PL
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2465
Mailing Address - Country:US
Mailing Address - Phone:810-767-5750
Mailing Address - Fax:810-237-7582
Practice Address - Street 1:806 TUURI PL
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2465
Practice Address - Country:US
Practice Address - Phone:810-767-5750
Practice Address - Fax:810-237-7582
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOTT CHILDREN'S HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty