Healthcare Provider Details

I. General information

NPI: 1104743897
Provider Name (Legal Business Name): EARL DAVID KIK II HEARING AID DEALER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 N US HIGHWAY 31 S
TRAVERSE CITY MI
49684-4520
US

IV. Provider business mailing address

2401 N US HIGHWAY 31 S
TRAVERSE CITY MI
49684-4520
US

V. Phone/Fax

Practice location:
  • Phone: 231-486-0234
  • Fax:
Mailing address:
  • Phone: 231-486-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3501004832
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: