Provider Demographics
NPI:1689087538
Name:INNOVATIVE EAR & HEARING
Entity Type:Organization
Organization Name:INNOVATIVE EAR & HEARING
Other - Org Name:HARTIG HEARING CARE AND OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTIG
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:586-991-0450
Mailing Address - Street 1:1620 JFK RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-5302
Mailing Address - Country:US
Mailing Address - Phone:563-582-1120
Mailing Address - Fax:563-582-4327
Practice Address - Street 1:1620 JFK RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-5302
Practice Address - Country:US
Practice Address - Phone:563-582-1120
Practice Address - Fax:563-582-4327
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INNOVATIVE EAR & HEARING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty