Healthcare Provider Details

I. General information

NPI: 1841327368
Provider Name (Legal Business Name): KREITL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 01/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12154 GREEN RD
GOODRICH MI
48438-9740
US

IV. Provider business mailing address

12154 GREEN RD
GOODRICH MI
48438-9740
US

V. Phone/Fax

Practice location:
  • Phone: 810-636-2738
  • Fax: 810-636-2739
Mailing address:
  • Phone: 810-636-2738
  • Fax: 810-636-2739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number3501002674
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3501002674
License Number StateMI

VIII. Authorized Official

Name: KATHRYN A BJEKICH
Title or Position: DEALER
Credential: BCHIS
Phone: 248-597-2044