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General NPI Number Information
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NPI Number | 1902256282
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Entity Type | Organization
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Legal Business Name | HEARING ADVANTAGE LLC
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 2234 NEVA RD
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City | ANTIGO
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State | WI
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Zip | 54409-2910
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Country | US
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Telephone | 888-897-3711
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Fax | 715-420-1686
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Provider Business Mailing Address
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Address Line | 181 S ANDERSON ST
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City | RHINELANDER
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State | WI
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Zip | 54501-3448
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Country | US
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Telephone | 888-897-3711
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Fax | 715-420-1686
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Authorized Official
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Title or Position | OWNER
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Name | JESSE KASTER
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Credential |
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Telephone | 715-362-3711
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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 | 1390060
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License Number State | WI
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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 | 1229060
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License Number State | WI
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