Provider Demographics
NPI:1841744687
Name:POOLE, LEN (HIS)
Entity Type:Individual
Prefix:MR
First Name:LEN
Middle Name:
Last Name:POOLE
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WHITE BRIDGE RD
Mailing Address - Street 2:STE 116
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1497
Mailing Address - Country:US
Mailing Address - Phone:615-353-5600
Mailing Address - Fax:
Practice Address - Street 1:95 WHITE BRIDGE RD
Practice Address - Street 2:STE 116
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1497
Practice Address - Country:US
Practice Address - Phone:615-353-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN870237700000X
GA000952237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist