Provider Demographics
NPI:1417381922
Name:BAY HEARING CONSERVATION, INC.
Entity Type:Organization
Organization Name:BAY HEARING CONSERVATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:KURLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:920-499-6366
Mailing Address - Street 1:1600 SHAWANO AVE
Mailing Address - Street 2:SUITE 110W
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-3246
Mailing Address - Country:US
Mailing Address - Phone:920-499-6366
Mailing Address - Fax:920-499-2981
Practice Address - Street 1:1600 SHAWANO AVE
Practice Address - Street 2:SUITE 110W
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-3246
Practice Address - Country:US
Practice Address - Phone:920-499-6366
Practice Address - Fax:920-499-2981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26-156332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment