Provider Demographics
NPI:1497265870
Name:MIDSTATE HEARING INC.
Entity Type:Organization
Organization Name:MIDSTATE HEARING INC.
Other - Org Name:AUDIBEL HEARING SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLINTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:309-685-0887
Mailing Address - Street 1:3801 GE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4193
Mailing Address - Country:US
Mailing Address - Phone:309-662-9552
Mailing Address - Fax:
Practice Address - Street 1:3801 GE RD STE 1
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4193
Practice Address - Country:US
Practice Address - Phone:309-662-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty