Provider Demographics
NPI:1881019750
Name:MID-MISSOURI HEARING AND BALANCE, INC.
Entity Type:Organization
Organization Name:MID-MISSOURI HEARING AND BALANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:573-544-4264
Mailing Address - Street 1:850 W. HOSPITAL DRIVE
Mailing Address - Street 2:STE. F
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251
Mailing Address - Country:US
Mailing Address - Phone:573-544-7402
Mailing Address - Fax:
Practice Address - Street 1:850 W. HOSPITAL DRIVE
Practice Address - Street 2:STE. G
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251
Practice Address - Country:US
Practice Address - Phone:573-544-7402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001031974237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty