Provider Demographics
NPI:1760553531
Name:CHARLES A REGER & ASSOCIATES INC
Entity Type:Organization
Organization Name:CHARLES A REGER & ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:REGER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:574-243-7766
Mailing Address - Street 1:425 PARK PLACE CIR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3563
Mailing Address - Country:US
Mailing Address - Phone:574-243-7766
Mailing Address - Fax:574-243-7796
Practice Address - Street 1:425 PARK PLACE CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3563
Practice Address - Country:US
Practice Address - Phone:574-243-7766
Practice Address - Fax:574-243-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001942231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty