Provider Demographics
NPI:1164975223
Name:KMY AUDIOLOGY
Entity Type:Organization
Organization Name:KMY AUDIOLOGY
Other - Org Name:BELTONE HEARING & AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KYLIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:937-548-4242
Mailing Address - Street 1:303 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1906
Mailing Address - Country:US
Mailing Address - Phone:937-548-4242
Mailing Address - Fax:937-548-4562
Practice Address - Street 1:303 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1906
Practice Address - Country:US
Practice Address - Phone:937-548-4242
Practice Address - Fax:937-548-4562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02018231H00000X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty