Provider Demographics
NPI:1821274929
Name:HEARING CRAFTERS OF AMERICA INC
Entity Type:Organization
Organization Name:HEARING CRAFTERS OF AMERICA INC
Other - Org Name:HEARING CRAFTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-466-4245
Mailing Address - Street 1:708 E MT VERNON BLVD
Mailing Address - Street 2:PO BOX 269
Mailing Address - City:MT VERNON
Mailing Address - State:MO
Mailing Address - Zip Code:65712
Mailing Address - Country:US
Mailing Address - Phone:417-466-4245
Mailing Address - Fax:417-466-4085
Practice Address - Street 1:708 E MT VERNON BLVD
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:MO
Practice Address - Zip Code:65712
Practice Address - Country:US
Practice Address - Phone:417-466-4245
Practice Address - Fax:417-466-4085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO237700000X
OK237700000X
TX237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty