Healthcare Provider Details

I. General information

NPI: 1386833259
Provider Name (Legal Business Name): AUDIOLOGY & HEARING SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 S ONEIDA ST
APPLETON WI
54915-1657
US

IV. Provider business mailing address

2245 S ONEIDA ST
APPLETON WI
54915-1657
US

V. Phone/Fax

Practice location:
  • Phone: 920-731-9611
  • Fax: 920-731-1950
Mailing address:
  • Phone: 920-731-9611
  • Fax: 920-731-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number165
License Number StateWI

VIII. Authorized Official

Name: DR. MICHAEL K THELEN, AU.D.
Title or Position: DOCTOR OF AUDIOLOGY/OWNER
Credential: AU.D.
Phone: 920-731-9611