Provider Demographics
NPI:1114096716
Name:KACZMARSKI HEARING SERVICES, INC
Entity Type:Organization
Organization Name:KACZMARSKI HEARING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KACZMARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:616-538-8220
Mailing Address - Street 1:2225 MAIN ST SW
Mailing Address - Street 2:SUITE #140
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-9697
Mailing Address - Country:US
Mailing Address - Phone:616-538-8220
Mailing Address - Fax:616-538-8991
Practice Address - Street 1:2225 MAIN ST SW
Practice Address - Street 2:SUITE #140
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-9697
Practice Address - Country:US
Practice Address - Phone:616-538-8220
Practice Address - Fax:616-538-8991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501002053237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty