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General NPI Number Information
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NPI Number | 1215626080
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Entity Type | Organization
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Legal Business Name | VITA HEARING CARE, LLC
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Dates
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Enumeration Date | 05/05/2023
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 808A FOX LN
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City | WATERFORD
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State | WI
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Zip | 53185-4511
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Country | US
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Telephone | 262-332-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 808A FOX LN
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City | WATERFORD
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State | WI
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Zip | 53185-4511
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Country | US
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Telephone | 262-332-6700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY S GILANE
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Credential | B.A., H.I.S.
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Telephone | 126-288-3009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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