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General NPI Number Information
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NPI Number | 1649136730
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Entity Type | Organization
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Legal Business Name | MIDWEST AUDIOLOGY & HEARING CENTER BEAVER DAM LLC
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Dates
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Enumeration Date | 01/01/2026
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 106 FRANCES LN STE F
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City | BEAVER DAM
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State | WI
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Zip | 53916-1167
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Country | US
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Telephone | 920-319-4219
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Fax |
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Provider Business Mailing Address
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Address Line | 106 FRANCES LN STE F
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City | BEAVER DAM
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State | WI
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Zip | 53916-1167
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Country | US
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Telephone | 920-319-4219
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE/CREDENTIALING
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Name | JULIE BARTH
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Credential | DM
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Telephone | 920-234-8542
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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 |
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License Number State |
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