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General NPI Number Information
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NPI Number | 1417381922
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Entity Type | Organization
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Legal Business Name | BAY HEARING CONSERVATION, INC.
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 1600 SHAWANO AVE SUITE 110W
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City | GREEN BAY
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State | WI
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Zip | 54303-3246
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Country | US
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Telephone | 920-499-6366
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Fax | 920-499-2981
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Provider Business Mailing Address
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Address Line | 1600 SHAWANO AVE SUITE 110W
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City | GREEN BAY
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State | WI
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Zip | 54303-3246
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Country | US
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Telephone | 920-499-6366
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Fax | 920-499-2981
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | MR. PAUL F. KURLAND
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Credential | M.A.
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Telephone | 920-499-6366
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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 | 26-156
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License Number State | WI
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