Provider Demographics
NPI:1043785355
Name:LIFETIME HEARING LLC
Entity Type:Organization
Organization Name:LIFETIME HEARING LLC
Other - Org Name:LIFETIME HEARING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DOSSIN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:810-252-0339
Mailing Address - Street 1:1273 GRATIOT BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-2303
Mailing Address - Country:US
Mailing Address - Phone:810-364-1170
Mailing Address - Fax:
Practice Address - Street 1:1273 GRATIOT BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48040-2303
Practice Address - Country:US
Practice Address - Phone:810-364-1170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty