Provider Demographics
NPI:1750658175
Name:WRIGHT, BRAD J (HEARING AID DEALER)
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:J
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:HEARING AID DEALER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-5319
Mailing Address - Country:US
Mailing Address - Phone:765-453-0200
Mailing Address - Fax:765-453-0220
Practice Address - Street 1:931 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-5319
Practice Address - Country:US
Practice Address - Phone:765-453-0200
Practice Address - Fax:765-453-0220
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001375A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist