Healthcare Provider Details

I. General information

NPI: 1942553193
Provider Name (Legal Business Name): JKL HEARING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 JOHN MORROW PKWY
GAINESVILLE GA
30501
US

IV. Provider business mailing address

237 JOHN MORROW PKWY
GAINESVILLE GA
30501
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-5552
  • Fax: 770-814-9772
Mailing address:
  • Phone: 770-536-5552
  • Fax: 770-814-9772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberHADE034993
License Number StateGA

VIII. Authorized Official

Name: MS. JANE L LEWIS
Title or Position: OWNER
Credential:
Phone: 770-519-6400