Healthcare Provider Details

I. General information

NPI: 1023231446
Provider Name (Legal Business Name): WISCONSIN HEARING AID CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9211 W CAPITOL DR
MILWAUKEE WI
53222-1532
US

IV. Provider business mailing address

9211 W CAPITOL DR
MILWAUKEE WI
53222-1532
US

V. Phone/Fax

Practice location:
  • Phone: 414-463-0200
  • Fax: 414-272-1467
Mailing address:
  • Phone: 414-463-0200
  • Fax: 414-272-1467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. KIM PETERSON
Title or Position: PRESIDENT - CEO
Credential: H.I.S.
Phone: 414-463-0200