Provider Demographics
NPI:1942481338
Name:EAR TECHNOLOGY INC.
Entity Type:Organization
Organization Name:EAR TECHNOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUNBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:801-399-9955
Mailing Address - Street 1:3955 HARRISON BLVD
Mailing Address - Street 2:SUITE U7
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2313
Mailing Address - Country:US
Mailing Address - Phone:801-399-9955
Mailing Address - Fax:801-399-3144
Practice Address - Street 1:3955 HARRISON BLVD
Practice Address - Street 2:SUITE U7
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2313
Practice Address - Country:US
Practice Address - Phone:801-399-9955
Practice Address - Fax:801-399-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4827256-4101174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000055919Medicare PIN