Provider Demographics
NPI:1255646170
Name:PERINE, CHARLES ALAN (AUD)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:ALAN
Last Name:PERINE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:40 N. GRAND AVE. SUITE 103
Mailing Address - Street 2:HEAD & NECK SURGERY ASSOC. PSC
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075
Mailing Address - Country:US
Mailing Address - Phone:859-781-4900
Mailing Address - Fax:859-572-3039
Practice Address - Street 1:368 BIELBY RD SUITE 140
Practice Address - Street 2:LUDLOW HILL PREOFESSIONAL BLDG
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025
Practice Address - Country:US
Practice Address - Phone:812-537-5510
Practice Address - Fax:812-537-4138
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist