NPI 1487896114

Park Place Declarant

Organisation Hearing Aid Equipment Lake Havasu City, AZ

Practice location

Address: 2105 McCulloch Blvd N #2, Lake Havasu City, AZ 86403-6772
Phone: (702) 807-7931
Fax: (702) 398-3757
Mailing address: PO Box 224, Logandale, NV 89021-0224

Authorised official

Name: Suzanne Kelly
Title: Owner
Phone: (702) 807-7931

Registered specialties

Hearing Aid Equipment Primary

Suppliers Taxonomy 332S00000X Licence HAD5806 (AZ)

Other Hearing Aid Equipment providers in Arizona →

Registry record

NPI: 1487896114
Entity type: Organization
NPI issued: 26 Mar 2009
Record last updated: 26 Mar 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.