Provider Demographics
NPI:1801053400
Name:KNAPP HEARING AID CENTERS
Entity type:Organization
Organization Name:KNAPP HEARING AID CENTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:PETITTE
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC/A
Authorized Official - Phone:304-842-3050
Mailing Address - Street 1:1400 JOHNSON AVE STE 4N
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1063
Mailing Address - Country:US
Mailing Address - Phone:304-842-3050
Mailing Address - Fax:304-842-5733
Practice Address - Street 1:829 FAIRMONT RD STE 106
Practice Address - Street 2:
Practice Address - City:WESTOVER
Practice Address - State:WV
Practice Address - Zip Code:26501-3892
Practice Address - Country:US
Practice Address - Phone:304-296-3357
Practice Address - Fax:304-296-8044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KNAPP HEARING AID CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT-005891332B00000X
WVA-0177332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies