Provider Demographics
NPI:1356564884
Name:ENT MEDICAL SERVICES HEARING AID SERVICES
Entity type:Organization
Organization Name:ENT MEDICAL SERVICES HEARING AID SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-351-5680
Mailing Address - Street 1:2615 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-9565
Mailing Address - Country:US
Mailing Address - Phone:319-351-5680
Mailing Address - Fax:319-351-8980
Practice Address - Street 1:2615 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9565
Practice Address - Country:US
Practice Address - Phone:319-351-5680
Practice Address - Fax:319-351-8980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA104231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty