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General NPI Number Information
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NPI Number | 1528285715
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Entity Type | Organization
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Legal Business Name | HEARING BASILIA CORPORATION
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2211 OREGON ST STE I
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City | OSHKOSH
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State | WI
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Zip | 54902-7001
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Country | US
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Telephone | 920-966-2700
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Fax | 920-966-6060
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Provider Business Mailing Address
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Address Line | 2211 OREGON ST STE I
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City | OSHKOSH
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State | WI
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Zip | 54902-7001
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Country | US
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Telephone | 920-966-2700
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Fax | 920-966-6060
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Authorized Official
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Title or Position | HEARING INSTRUMENT SPECIALIST
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Name | RYAN R BLAIR
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Credential | HIS
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Telephone | 920-966-2700
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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 | 1259-060
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License Number State | WI
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