Organization
WISCONSIN HEARING AID CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIM PETERSON H.I.S. (PRESIDENT - CEO)
(414) 463-0200
Entity
Organization
Contact information
Practice address
1300 S GREENBAY RD, SUITE 104, RACINE, WI 53406-4469
(262) 634-4500
Mailing address
1300 S GREENBAY RD, SUITE 104, RACINE, WI 53406-4469
(262) 634-4500
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42857700
—
WI
Enumeration date
05/15/2007
Last updated
05/06/2015
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