Healthcare Provider Details
I. General information
NPI: 1447089099
Provider Name (Legal Business Name): JKHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2024
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4600 MILITARY TRL STE 108
JUPITER FL
33458-4811
US
IV. Provider business mailing address
4600 MILITARY TRL STE 108
JUPITER FL
33458-4811
US
V. Phone/Fax
- Phone: 561-260-5555
- Fax: 561-941-9347
- Phone: 561-260-5555
- Fax: 561-941-9347
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KURT
EVAN
WALKER
Title or Position: AUDIOLOGIST
Credential: AU.D.
Phone: 319-329-2016