Provider Demographics
NPI:1497811210
Name:PRECISION HEARING INSTRUMENTS
Entity Type:Organization
Organization Name:PRECISION HEARING INSTRUMENTS
Other - Org Name:MIRACLE-EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WISNIEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:608-829-3777
Mailing Address - Street 1:6514 ODANA RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1124
Mailing Address - Country:US
Mailing Address - Phone:608-829-3777
Mailing Address - Fax:608-829-0430
Practice Address - Street 1:6514 ODANA RD
Practice Address - Street 2:SUITE 7
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1124
Practice Address - Country:US
Practice Address - Phone:608-829-3777
Practice Address - Fax:608-829-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI730 - 060237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42826800Medicaid
MN60Q19MIOtherBCBS MN GROUP NUMBER
MN60Q19MIOtherBCBS MN GROUP NUMBER