Provider Demographics
NPI:1730411778
Name:HEAR FOR LIFE, INC
Entity type:Organization
Organization Name:HEAR FOR LIFE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:V
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:478-477-7700
Mailing Address - Street 1:3759 VINEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1854
Mailing Address - Country:US
Mailing Address - Phone:478-477-7700
Mailing Address - Fax:
Practice Address - Street 1:3759 VINEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-1854
Practice Address - Country:US
Practice Address - Phone:478-477-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003673231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty