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General NPI Number Information
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NPI Number | 1538430236
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Entity Type | Organization
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Legal Business Name | SHORELINE HEARING CENTER LLC
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 941 W BROADWAY AVE
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City | MUSKEGON
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State | MI
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Zip | 49441-3521
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Country | US
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Telephone | 231-755-0552
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Fax | 231-755-0560
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Provider Business Mailing Address
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Address Line | 941 W BROADWAY AVE
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City | MUSKEGON
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State | MI
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Zip | 49441-3521
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Country | US
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Telephone | 231-755-0552
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Fax | 231-755-5600
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY KEESSEN
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Credential | AUD
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Telephone | 231-755-0552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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