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General NPI Number Information
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NPI Number | 1770894388
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Entity Type | Organization
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Legal Business Name | HEAR MICHIGAN ONE LLC
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 12/21/2010
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Provider Practice Location Address
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Address Line | 400 S STATE ST SUITE 260
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City | ZEELAND
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State | MI
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Zip | 49464-2067
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Country | US
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Telephone | 616-772-9822
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Fax | 616-772-9834
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Provider Business Mailing Address
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Address Line | 400 S STATE ST SUITE 260
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City | ZEELAND
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State | MI
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Zip | 49464-2067
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Country | US
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Telephone | 616-772-9822
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Fax | 616-772-9834
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Authorized Official
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Title or Position | PRESIDENT
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Name | LYLE KARP
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Credential |
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Telephone | 616-772-9822
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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 | 1601000328
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 1601000328
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License Number State | MI
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