Provider Demographics
NPI:1609102326
Name:LJZR ENTERPRISES LLC
Entity Type:Organization
Organization Name:LJZR ENTERPRISES LLC
Other - Org Name:MIRACLE EAR LAS VEGAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR. AUDIOLOGY/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:JEZIORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:AU D
Authorized Official - Phone:702-460-5398
Mailing Address - Street 1:PO BOX 33534
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133
Mailing Address - Country:US
Mailing Address - Phone:702-259-4944
Mailing Address - Fax:702-259-4945
Practice Address - Street 1:4700 MEADOWS LANE
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107
Practice Address - Country:US
Practice Address - Phone:702-259-4944
Practice Address - Fax:702-259-4945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment