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General NPI Number Information
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NPI Number | 1932348364
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Entity Type | Organization
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Legal Business Name | HEARING HEALTHCARE MID-KANSAS LLC
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 310 W CENTRAL AVE SUITE L
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City | ANDOVER
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State | KS
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Zip | 67002-9688
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Country | US
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Telephone | 316-618-0331
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Fax |
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Provider Business Mailing Address
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Address Line | 207 N TERRACE DR
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City | WICHITA
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State | KS
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Zip | 67208-3943
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Country | US
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Telephone | 316-618-0331
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Fax |
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Authorized Official
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Title or Position | OWNER/AUDIOLOGIST
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Name | MR. STEVEN HOLLIS BRADBURY
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Credential | M.A.
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Telephone | 316-618-0331
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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 | 429
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License Number State | KS
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