Provider Demographics
NPI:1629204482
Name:MICROTONE HEARING INSTRUMENTS INC. EAST
Entity Type:Organization
Organization Name:MICROTONE HEARING INSTRUMENTS INC. EAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:HOLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-320-2871
Mailing Address - Street 1:325 CLAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3803
Mailing Address - Country:US
Mailing Address - Phone:570-320-2871
Mailing Address - Fax:570-320-0353
Practice Address - Street 1:325 CLAYTON AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3803
Practice Address - Country:US
Practice Address - Phone:570-320-2871
Practice Address - Fax:570-320-0353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO3169332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment