Healthcare Provider Details
I. General information
NPI: 1326234956
Provider Name (Legal Business Name): ADVANCED HEARING SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2331 VELP AVE SUITE G
GREEN BAY WI
54303-6592
US
IV. Provider business mailing address
2331 VELP AVE SUITE G
GREEN BAY WI
54303-6592
US
V. Phone/Fax
- Phone: 920-434-6777
- Fax: 920-434-6988
- Phone: 920-434-6777
- Fax: 920-434-6988
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | 464 |
| License Number State | WI |
VIII. Authorized Official
Name: DR.
JANET
MARIE
THIBERT
Title or Position: OWNER
Credential: AU.D.
Phone: 920-434-6777