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General NPI Number Information
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NPI Number | 1447378773
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Entity Type | Organization
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Legal Business Name | PERSONALIZED HEARING CARE
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 35337 WARREN RD
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City | WESTLAND
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State | MI
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Zip | 48185-2013
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Country | US
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Telephone | 734-467-5100
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Fax | 734-467-5103
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Provider Business Mailing Address
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Address Line | 35337 WARREN RD
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City | WESTLAND
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State | MI
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Zip | 48185-2013
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Country | US
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Telephone | 734-467-5100
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Fax | 734-467-5103
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. KARISSA L JAGACKI
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Credential | AU.D.
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Telephone | 734-467-5100
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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 | 1601000113
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License Number State | MI
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