Basic Information
| Provider Information | |||||||||
| NPI: | 1003011743 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRAKER | ||||||||
| FirstName: | MARTA | ||||||||
| MiddleName: | KAY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 85 | ||||||||
| Address2: | |||||||||
| City: | MARSHFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657060085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4174259732 | ||||||||
| FaxNumber: | 4178897077 | ||||||||
| Practice Location | |||||||||
| Address1: | 3250 E BATTLEFIELD ST STE N | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658044081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178897500 | ||||||||
| FaxNumber: | 4178897077 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 2000152517 | MO | X | Speech, Language and Hearing Service Providers | Audiologist | 237700000X | 001277 | MO | X | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.