Provider Demographics
NPI:1699165639
Name:MITCHELL HEARING AIDE CENTER INC.
Entity type:Organization
Organization Name:MITCHELL HEARING AIDE CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WAHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-352-1585
Mailing Address - Street 1:1288 DAKOTA S.
Mailing Address - Street 2:SUITE #1
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350
Mailing Address - Country:US
Mailing Address - Phone:605-332-1585
Mailing Address - Fax:605-352-9046
Practice Address - Street 1:1288 DAKOTA S.
Practice Address - Street 2:SUITE #1
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350
Practice Address - Country:US
Practice Address - Phone:605-332-1585
Practice Address - Fax:605-352-9046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MITCHELL HEARING AID CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD288H237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty