Provider Demographics
NPI:1720507734
Name:G L WYENO HEARING SPECIALISTS PC
Entity Type:Organization
Organization Name:G L WYENO HEARING SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WYENO
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:402-463-2431
Mailing Address - Street 1:2115 N KANSAS AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-2615
Mailing Address - Country:US
Mailing Address - Phone:402-463-2431
Mailing Address - Fax:402-463-2486
Practice Address - Street 1:2115 N KANSAS AVE STE 203
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2615
Practice Address - Country:US
Practice Address - Phone:402-463-2431
Practice Address - Fax:402-463-2486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE42231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty