Provider Demographics
NPI:1932348364
Name:HEARING HEALTHCARE MID-KANSAS LLC
Entity Type:Organization
Organization Name:HEARING HEALTHCARE MID-KANSAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:HOLLIS
Authorized Official - Last Name:BRADBURY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:316-618-0331
Mailing Address - Street 1:207 N TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3943
Mailing Address - Country:US
Mailing Address - Phone:316-618-0331
Mailing Address - Fax:
Practice Address - Street 1:310 W CENTRAL AVE
Practice Address - Street 2:SUITE L
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-9688
Practice Address - Country:US
Practice Address - Phone:316-618-0331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS429237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty