Healthcare Provider Details

I. General information

NPI: 1699865469
Provider Name (Legal Business Name): COMPREHENSIVE HEARING CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GENOA BUSINESS PARK DR SUITE 130
BRIGHTON MI
48114-7367
US

IV. Provider business mailing address

2300 GENOA BUSINESS PARK DR SUITE 130
BRIGHTON MI
48114-7367
US

V. Phone/Fax

Practice location:
  • Phone: 810-225-2205
  • Fax: 810-225-2209
Mailing address:
  • Phone: 810-225-2205
  • Fax: 810-225-2209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000209
License Number StateMI

VIII. Authorized Official

Name: MRS. LORI KAY LINGO
Title or Position: OWNER AUDIOLOGIST
Credential: M.ED CCC A
Phone: 810-225-2205