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General NPI Number Information
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NPI Number | 1215350251
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Entity Type | Organization
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Legal Business Name | MIDWEST AUDIOLOGY & HEARING CENTER, LLC
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Dates
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Enumeration Date | 01/28/2014
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 4818 S 76TH ST SUITE 3
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City | GREENFIELD
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State | WI
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Zip | 53220-4362
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Country | US
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Telephone | 414-281-8300
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Fax | 414-455-0159
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Provider Business Mailing Address
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Address Line | 4818 S 76TH ST STE 12
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City | GREENFIELD
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State | WI
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Zip | 53220-4362
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Country | US
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Telephone | 414-281-8300
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Fax | 414-455-0159
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DOUGLAS A KLOSS
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Credential | AUD
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Telephone | 414-281-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 152156
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License Number State | WI
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