Provider Demographics
NPI:1699072280
Name:AMERICAN HEARING AID CENTER AND AUDIOLOGY SERVICES
Entity type:Organization
Organization Name:AMERICAN HEARING AID CENTER AND AUDIOLOGY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:WITZKE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:405-842-8377
Mailing Address - Street 1:5820 N MAY AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4282
Mailing Address - Country:US
Mailing Address - Phone:405-842-8377
Mailing Address - Fax:
Practice Address - Street 1:5820 N MAY AVE
Practice Address - Street 2:SUITE C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4282
Practice Address - Country:US
Practice Address - Phone:405-842-8377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3684231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty