Provider Demographics
NPI:1871927129
Name:HURON VALLEY HEARING
Entity type:Organization
Organization Name:HURON VALLEY HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:WANDZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-889-7600
Mailing Address - Street 1:820 BYRON RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1098
Mailing Address - Country:US
Mailing Address - Phone:517-548-5900
Mailing Address - Fax:517-548-5982
Practice Address - Street 1:820 BYRON RD
Practice Address - Street 2:SUITE 500
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1098
Practice Address - Country:US
Practice Address - Phone:517-548-5900
Practice Address - Fax:517-548-5982
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HURON VALLEY HEARING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000645231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty