Healthcare Provider Details

I. General information

NPI: 1205885415
Provider Name (Legal Business Name): JOHANNA JEAN ZUEHLS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 10TH AVE
MENOMINEE MI
49858-3012
US

IV. Provider business mailing address

705 10TH AVE P.O. BOX 473
MENOMINEE MI
49858-3012
US

V. Phone/Fax

Practice location:
  • Phone: 906-864-2945
  • Fax: 906-864-2957
Mailing address:
  • Phone: 906-864-2945
  • Fax: 906-864-2957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3501004565
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: