Provider Demographics
NPI:1124423629
Name:LINDA M DOVER
Entity type:Organization
Organization Name:LINDA M DOVER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-727-4177
Mailing Address - Street 1:30 W MCCREIGHT AVE
Mailing Address - Street 2:STE 107
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1853
Mailing Address - Country:US
Mailing Address - Phone:937-727-4177
Mailing Address - Fax:937-727-4177
Practice Address - Street 1:30 W MCCREIGHT AVE
Practice Address - Street 2:STE 107
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1853
Practice Address - Country:US
Practice Address - Phone:937-727-4177
Practice Address - Fax:937-727-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty