Provider Demographics
NPI:1801200910
Name:PRIVATE PRACTICE HEALTHCARE SOLUTIONS
Entity Type:Organization
Organization Name:PRIVATE PRACTICE HEALTHCARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:NORVELL
Authorized Official - Suffix:
Authorized Official - Credentials:BS, ACA
Authorized Official - Phone:740-453-1103
Mailing Address - Street 1:735 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1877
Mailing Address - Country:US
Mailing Address - Phone:740-453-1103
Mailing Address - Fax:740-453-2733
Practice Address - Street 1:735 PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1877
Practice Address - Country:US
Practice Address - Phone:740-453-1103
Practice Address - Fax:740-453-2733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02255237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty