Provider Demographics
NPI:1154562395
Name:KANZAN ENTERPRISES INC
Entity type:Organization
Organization Name:KANZAN ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:BARY
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:620-481-4677
Mailing Address - Street 1:1727 HAMMOND DR
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-5312
Mailing Address - Country:US
Mailing Address - Phone:620-481-4677
Mailing Address - Fax:620-343-6007
Practice Address - Street 1:13460 N 94TH DR
Practice Address - Street 2:SUITE G-2
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4835
Practice Address - Country:US
Practice Address - Phone:623-933-0000
Practice Address - Fax:623-933-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA6116237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty