Provider Demographics
NPI:1285016832
Name:CHAMBERS & CLARK HEARING LLC
Entity type:Organization
Organization Name:CHAMBERS & CLARK HEARING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:ACA
Authorized Official - Phone:270-842-8932
Mailing Address - Street 1:730 FAIRVIEW AVE
Mailing Address - Street 2:SUITE A4
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-2367
Mailing Address - Country:US
Mailing Address - Phone:270-842-8932
Mailing Address - Fax:270-796-2054
Practice Address - Street 1:730 FAIRVIEW AVE
Practice Address - Street 2:SUITE A4
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2367
Practice Address - Country:US
Practice Address - Phone:270-842-8932
Practice Address - Fax:270-796-2054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY0697237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty