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Organization
PERSONALIZED HEARING CARE
Active
Organization
PERSONALIZED HEARING CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARISSA L JAGACKI AU.D. (AUDIOLOGIST)
(734) 467-5100
Entity
Organization
Contact information
Practice address
35337 WARREN RD, WESTLAND, MI 48185-2013
(734) 467-5100
(734) 467-5103
Mailing address
35337 WARREN RD, WESTLAND, MI 48185-2013
(734) 467-5100
(734) 467-5103
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000113
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H10426
BLUE CARE NETWORK
MI
01
—
237600000X
PROVIDER TAXONOMIES
MI
05
—
4433772
—
MI
05
—
4704347
—
MI
01
—
540H104260
BLUE CROSS BLUE SHIELD
MI
01
—
640H227530
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/26/2007
Last updated
02/27/2013
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