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General NPI Number Information
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NPI Number | 1942481338
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Entity Type | Organization
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Legal Business Name | EAR TECHNOLOGY INC.
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 3955 HARRISON BLVD SUITE U7
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City | OGDEN
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State | UT
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Zip | 84403-2313
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Country | US
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Telephone | 801-399-9955
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Fax | 801-399-3144
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Provider Business Mailing Address
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Address Line | 3955 HARRISON BLVD SUITE U7
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City | OGDEN
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State | UT
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Zip | 84403-2313
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Country | US
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Telephone | 801-399-9955
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Fax | 801-399-3144
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY
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Name | KERRY BRAUNBERGER
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Credential | AU.D.
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Telephone | 801-399-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4827256-4101
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License Number State | UT
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