Organization
BASIN HEARING SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELCI LEE JACKSON AU.D. (AUDIOLOGIST)
(701) 572-1077
Entity
Organization
Contact information
Practice address
104 MAIN ST, WILLISTON, ND 58801-6019
(701) 572-1077
Mailing address
104 MAIN ST, WILLISTON, ND 58801-6019
(701) 572-1077
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1465789
—
ND
Enumeration date
07/28/2022
Last updated
12/02/2022
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