Provider Demographics
NPI:1033717160
Name:KDR HEARING TECHNOLOGIES LLC
Entity Type:Organization
Organization Name:KDR HEARING TECHNOLOGIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ HEARING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHR
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING AID DISPENSE
Authorized Official - Phone:505-263-2997
Mailing Address - Street 1:6115 DOWNEY ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-2633
Mailing Address - Country:US
Mailing Address - Phone:055-263-2997
Mailing Address - Fax:
Practice Address - Street 1:107 S SECOND ST
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-6219
Practice Address - Country:US
Practice Address - Phone:505-263-2997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty