Provider Demographics
NPI:1538582218
Name:PERSONAL EAR PRODUCTS, LLC
Entity type:Organization
Organization Name:PERSONAL EAR PRODUCTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/A
Authorized Official - Phone:469-893-9090
Mailing Address - Street 1:4950 KELLER SPRINGS RD STE 190
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-5929
Mailing Address - Country:US
Mailing Address - Phone:469-893-9090
Mailing Address - Fax:972-458-0234
Practice Address - Street 1:4950 KELLER SPRINGS RD STE 190
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-5929
Practice Address - Country:US
Practice Address - Phone:469-893-9090
Practice Address - Fax:972-458-0234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty