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General NPI Number Information
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NPI Number | 1467704924
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Entity Type | Organization
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Legal Business Name | HIGHLAND ENTERPRISES LLC
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 3006 W SHORE DR STE 60
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City | HOLLAND
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State | MI
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Zip | 49424-7508
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Country | US
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Telephone | 616-399-7277
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Fax |
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Provider Business Mailing Address
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Address Line | 384 N 3RD AVE STE D
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City | FRUITPORT
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State | MI
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Zip | 49415-9788
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN PETERSON
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Credential |
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Telephone | 231-865-7706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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