Healthcare Provider Details

I. General information

NPI: 1790016582
Provider Name (Legal Business Name): KANZAN HEARING CARE GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 W 74TH ST STE 150
SHAWNEE MISSION KS
66204-2282
US

IV. Provider business mailing address

1727 HAMMOND DR
EMPORIA KS
66801-5312
US

V. Phone/Fax

Practice location:
  • Phone: 913-384-5880
  • Fax: 913-384-9612
Mailing address:
  • Phone: 620-481-4681
  • Fax: 913-384-9612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BARY E WILLIAMS
Title or Position: OWNER
Credential: AU.D.
Phone: 620-481-4677