Provider Demographics
NPI:1255157897
Name:MEDICAL HEARING CLINIC, LLC
Entity type:Organization
Organization Name:MEDICAL HEARING CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KODY
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:801-399-5014
Mailing Address - Street 1:1100 COUNTRY HILLS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2511
Mailing Address - Country:US
Mailing Address - Phone:801-399-5014
Mailing Address - Fax:801-399-0830
Practice Address - Street 1:1100 COUNTRY HILLS DR STE 200
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2511
Practice Address - Country:US
Practice Address - Phone:801-399-5014
Practice Address - Fax:801-399-0830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty