Organization
EASY HEARING CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOREN DALE KMETT (PRESIDENT)
(218) 829-2162
Entity
Organization
Contact information
Practice address
215 N 3RD ST, BRAINERD, MN 56401-3331
(218) 829-2162
Mailing address
215 N 3RD ST, BRAINERD, MN 56401-3331
(218) 829-2162
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
7307
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161081
UCARE
MN
01
—
96G60EA
MN BLUE CROSS BLUE SHIELD
MN
Enumeration date
09/17/2006
Last updated
04/10/2008
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