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General NPI Number Information
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NPI Number | 1679152706
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Entity Type | Organization
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Legal Business Name | KEILMAN HEARING CENTER
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 214 E ELM AVE STE 111
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City | MONROE
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State | MI
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Zip | 48162-2678
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Country | US
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Telephone | 734-241-4080
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Fax | 734-241-4798
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Provider Business Mailing Address
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Address Line | 214 E ELM AVE STE 111
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City | MONROE
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State | MI
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Zip | 48162-2678
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Country | US
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Telephone | 734-241-4080
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Fax | 734-241-4798
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Authorized Official
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Title or Position | AUDIOPROTHOLOGIST/OWNER
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Name | MR. JASON WAYNE KEILMAN
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Credential | A.C.A, NBC-HIS
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Telephone | 734-241-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2355A2700X
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Taxonomy Name | Audiology Assistant
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License Number |
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License Number State |
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