Provider Demographics
NPI:1194159772
Name:CLEARLY HEARING INC
Entity type:Organization
Organization Name:CLEARLY HEARING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:JR
Authorized Official - Credentials:HIS
Authorized Official - Phone:928-342-6000
Mailing Address - Street 1:11665 S FORTUNA RD
Mailing Address - Street 2:STE A
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-7736
Mailing Address - Country:US
Mailing Address - Phone:928-342-6000
Mailing Address - Fax:928-569-0291
Practice Address - Street 1:11665 S FORTUNA RD
Practice Address - Street 2:STE A
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85367-7736
Practice Address - Country:US
Practice Address - Phone:928-342-6000
Practice Address - Fax:928-569-0291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZHAD8177237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty