Provider Demographics
NPI:1952653487
Name:HEARING AND AUDIOLOGY SEVICES, LLC
Entity Type:Organization
Organization Name:HEARING AND AUDIOLOGY SEVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRBAC
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:417-328-6535
Mailing Address - Street 1:2527 E GRAND ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-0440
Mailing Address - Country:US
Mailing Address - Phone:417-328-6535
Mailing Address - Fax:417-890-9127
Practice Address - Street 1:1300 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-3018
Practice Address - Country:US
Practice Address - Phone:417-328-6535
Practice Address - Fax:417-890-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01895231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty