Healthcare Provider Details

I. General information

NPI: 1881894947
Provider Name (Legal Business Name): ALL ABOUT HEARING SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2733 MANITOWOC RD STE 8B
GREEN BAY WI
54311-4901
US

IV. Provider business mailing address

2733 MANITOWOC RD STE 8B
GREEN BAY WI
54311-4901
US

V. Phone/Fax

Practice location:
  • Phone: 920-468-7474
  • Fax:
Mailing address:
  • Phone: 920-468-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number004-0001721014-01
License Number StateWI

VIII. Authorized Official

Name: DANIEL PANTZLAFF
Title or Position: CO-OWNER
Credential: H.I.S.
Phone: 920-468-7474