Provider Demographics
NPI:1932771730
Name:MIRACLE-EAR CENTERS OF ARKANSAS
Entity Type:Organization
Organization Name:MIRACLE-EAR CENTERS OF ARKANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-328-0088
Mailing Address - Street 1:3473 RIDER TRL S
Mailing Address - Street 2:
Mailing Address - City:EARTH CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63045-1110
Mailing Address - Country:US
Mailing Address - Phone:314-328-0088
Mailing Address - Fax:
Practice Address - Street 1:3473 RIDER TRL S
Practice Address - Street 2:
Practice Address - City:EARTH CITY
Practice Address - State:MO
Practice Address - Zip Code:63045-1110
Practice Address - Country:US
Practice Address - Phone:314-328-0088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty