Provider Demographics
NPI:1104976414
Name:HURON VALLEY HEARING, INC
Entity type:Organization
Organization Name:HURON VALLEY HEARING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:WANDZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-889-7600
Mailing Address - Street 1:222 W HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-4504
Mailing Address - Country:US
Mailing Address - Phone:248-889-7600
Mailing Address - Fax:248-889-5876
Practice Address - Street 1:222 W HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-4504
Practice Address - Country:US
Practice Address - Phone:248-889-7600
Practice Address - Fax:248-889-5876
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD A WANDZEL DO PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-11
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRW008319237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F333320OtherBCBSM