Organization
KENOSHA HEARING AID CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIM B PETERSON HIS (PRESIDENT)
(262) 654-4703
Entity
Organization
Contact information
Practice address
2527 75TH ST, KENOSHA, WI 53143-1407
(262) 654-4703
(262) 654-4703
Mailing address
2527 75TH ST, KENOSHA, WI 53143-1407
(262) 654-4703
(262) 654-4703
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42857000
—
WI
Enumeration date
06/01/2007
Last updated
06/26/2008
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