Provider Demographics
NPI:1063539492
Name:ASSOCIATED BALANCE & HEARING CLINICS, LLC
Entity type:Organization
Organization Name:ASSOCIATED BALANCE & HEARING CLINICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:POUL-ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:TRANSO
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-A
Authorized Official - Phone:608-375-4327
Mailing Address - Street 1:109 E BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:BOSCOBEL
Mailing Address - State:WI
Mailing Address - Zip Code:53805-1610
Mailing Address - Country:US
Mailing Address - Phone:608-375-4327
Mailing Address - Fax:608-375-2351
Practice Address - Street 1:109 E BLUFF ST
Practice Address - Street 2:
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805-1610
Practice Address - Country:US
Practice Address - Phone:608-375-4327
Practice Address - Fax:608-375-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI176-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty