Provider Demographics
NPI:1457652570
Name:LIBERTY HEARING LLC
Entity Type:Organization
Organization Name:LIBERTY HEARING LLC
Other - Org Name:LOCAL HEARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:BC HIS
Authorized Official - Phone:417-889-5353
Mailing Address - Street 1:3242 S NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7303
Mailing Address - Country:US
Mailing Address - Phone:417-889-5353
Mailing Address - Fax:417-889-5355
Practice Address - Street 1:3242 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7303
Practice Address - Country:US
Practice Address - Phone:417-889-5353
Practice Address - Fax:417-889-5355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment