Individual
KURT FAHRENBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D, CCC-A
Contact information
Practice address
2 W 42ND ST, SUITE 1100, SCOTTSBLUFF, NE 69361-4669
(308) 635-3155
(308) 635-2966
Mailing address
1600 BEVERLY BLVD, GERING, NE 69341-1914
(308) 635-3155
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
123
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123
—
NE
01
—
640002691
PALMENTO GBA RR MEDICARE
NE
Enumeration date
07/27/2006
Last updated
08/15/2011
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