Provider Demographics
NPI:1972864932
Name:KEVIN T BARLOW, PA. DBA: WINTER HAVEN AUDIOLOGY AND RIDGE AUDIOLOGY.
Entity Type:Organization
Organization Name:KEVIN T BARLOW, PA. DBA: WINTER HAVEN AUDIOLOGY AND RIDGE AUDIOLOGY.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-293-6507
Mailing Address - Street 1:704 SR 60 EAST
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853
Mailing Address - Country:US
Mailing Address - Phone:863-676-8900
Mailing Address - Fax:863-676-8971
Practice Address - Street 1:704 SR 60 EAST
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853
Practice Address - Country:US
Practice Address - Phone:863-676-8900
Practice Address - Fax:863-676-8971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech