Healthcare Provider Details

I. General information

NPI: 1659522399
Provider Name (Legal Business Name): GREENLUND ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 US HWY 41 W
MARQUETTE MI
49855
US

IV. Provider business mailing address

1802 GALLOWAY STREET
EAU CLAIRE WI
54703
US

V. Phone/Fax

Practice location:
  • Phone: 906-228-3577
  • Fax:
Mailing address:
  • Phone: 715-831-8966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: SCOTT LAU
Title or Position: FRANCHISE OWNER
Credential:
Phone: 715-831-8966