Provider Demographics
NPI:1922483288
Name:HEARTECH, LLC
Entity Type:Organization
Organization Name:HEARTECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLYLE
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-A
Authorized Official - Phone:423-785-7803
Mailing Address - Street 1:3310 ALTA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-4201
Mailing Address - Country:US
Mailing Address - Phone:423-785-7803
Mailing Address - Fax:423-698-3076
Practice Address - Street 1:3310 ALTA VISTA DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-4201
Practice Address - Country:US
Practice Address - Phone:423-785-7803
Practice Address - Fax:423-698-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA0000000082231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty