Provider Demographics
NPI:1881894947
Name:ALL ABOUT HEARING SERVICE LLC
Entity type:Organization
Organization Name:ALL ABOUT HEARING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTZLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:920-468-7474
Mailing Address - Street 1:2733 MANITOWOC RD STE 8B
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-4901
Mailing Address - Country:US
Mailing Address - Phone:920-468-7474
Mailing Address - Fax:
Practice Address - Street 1:2733 MANITOWOC RD STE 8B
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4901
Practice Address - Country:US
Practice Address - Phone:920-468-7474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI004-0001721014-01332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42857200Medicaid