Provider Demographics
NPI:1447963376
Name:WOLVERINE HEARING GROUP, LLC
Entity type:Organization
Organization Name:WOLVERINE HEARING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-720-2348
Mailing Address - Street 1:5661 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JCT
Mailing Address - State:MI
Mailing Address - Zip Code:49056-9545
Mailing Address - Country:US
Mailing Address - Phone:269-720-2348
Mailing Address - Fax:
Practice Address - Street 1:6 W JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6239
Practice Address - Country:US
Practice Address - Phone:509-483-1221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332S00000XSuppliersHearing Aid Equipment
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty