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General NPI Number Information
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NPI Number | 1982952271
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Entity Type | Organization
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Legal Business Name | SMART HEARING AND BALANCE OF LENEXA, LLC
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Dates
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Enumeration Date | 08/17/2012
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Last Update Date | 08/17/2012
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Provider Practice Location Address
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Address Line | 8550 MARSHALL DR SUITE 120
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City | LENEXA
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State | KS
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Zip | 66214-1505
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Country | US
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Telephone | 913-599-3275
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Fax | 913-599-3352
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Provider Business Mailing Address
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Address Line | 8550 MARSHALL DR SUITE 120
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City | LENEXA
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State | KS
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Zip | 66214-1505
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Country | US
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Telephone | 913-599-3275
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Fax | 913-599-3352
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY/OWNER
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Name | DR. MARIE WILLIS
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Credential | AU.D.
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Telephone | 913-599-3275
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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 | 2185
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License Number State | KS
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