Organization
GRAND HEARING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS A LOGEL JR. (OWNER - AUDIOLOGIST)
(517) 526-0390
Entity
Organization
Contact information
Practice address
1330 E GRAND RIVER AVE, SUITE B, PORTLAND, MI 48875-1630
(517) 526-0390
Mailing address
1330 E GRAND RIVER AVE, SUITE B, PORTLAND, MI 48875-1630
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000414
MI
332BC3200X
Customized Equipment (DME)
1601000414
MI
332S00000X
Hearing Aid Equipment
1601000414
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285671164
—
MI
Enumeration date
05/24/2011
Last updated
04/23/2012
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