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General NPI Number Information
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NPI Number | 1295033066
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Entity Type | Organization
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Legal Business Name | EARCARE HEARING AID CENTER WEST STREET WICHITA, INC.
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 125 S WEST ST STE 121
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City | WICHITA
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State | KS
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Zip | 67213-2113
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Country | US
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Telephone | 316-440-3750
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Fax | 316-440-3755
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Provider Business Mailing Address
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Address Line | 125 S WEST ST STE 121
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City | WICHITA
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State | KS
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Zip | 67213-2113
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Country | US
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Telephone | 316-440-3750
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Fax | 316-440-3755
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TIM BRECHEISEN
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Credential |
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Telephone | 316-269-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 1329
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License Number State | KS
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