Provider Demographics
NPI:1215248992
Name:JKL HEARING CENTER, INC.
Entity type:Organization
Organization Name:JKL HEARING CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-519-6400
Mailing Address - Street 1:1988 DOGWOOD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2398
Mailing Address - Country:US
Mailing Address - Phone:770-978-9702
Mailing Address - Fax:770-814-9772
Practice Address - Street 1:1988 DOGWOOD RD
Practice Address - Street 2:SUITE C
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2398
Practice Address - Country:US
Practice Address - Phone:770-978-9702
Practice Address - Fax:770-814-9772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADE034903332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment