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General NPI Number Information
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NPI Number | 1033717160
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Entity Type | Organization
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Legal Business Name | KDR HEARING TECHNOLOGIES LLC
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 107 S SECOND ST
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City | GALLUP
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State | NM
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Zip | 87301-6219
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Country | US
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Telephone | 505-263-2997
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Fax |
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Provider Business Mailing Address
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Address Line | 6115 DOWNEY ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2633
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Country | US
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Telephone | 55-263-2997
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Fax |
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Authorized Official
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Title or Position | OWNER/ HEARING SPECIALIST
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Name | KEITH ROHR
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Credential | HEARING AID DISPENSE
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Telephone | 505-263-2997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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