Provider Demographics
NPI:1548588650
Name:LIFETIME HEARING CLINIC, INC.
Entity Type:Organization
Organization Name:LIFETIME HEARING CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:615-443-4070
Mailing Address - Street 1:1430 W BADDOUR PKWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2656
Mailing Address - Country:US
Mailing Address - Phone:615-443-4070
Mailing Address - Fax:615-443-4432
Practice Address - Street 1:1430 W BADDOUR PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2656
Practice Address - Country:US
Practice Address - Phone:615-443-4070
Practice Address - Fax:615-443-4432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1291174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty