Provider Demographics
NPI:1588109912
Name:WEIGANDT HEARING LLC
Entity type:Organization
Organization Name:WEIGANDT HEARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:WEIGANDT
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING AID DEALER
Authorized Official - Phone:248-802-2566
Mailing Address - Street 1:1019 SHADY SHORE DR
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-1952
Mailing Address - Country:US
Mailing Address - Phone:248-802-2566
Mailing Address - Fax:
Practice Address - Street 1:1019 SHADY SHORE DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-1952
Practice Address - Country:US
Practice Address - Phone:248-802-2566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501005426237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty