Basic Information
| Provider Information | |||||||||
| NPI: | 1336757129 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GUZA HEARING ENHANCEMENT INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3856 170TH AVE | ||||||||
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| City: | MINNEOTA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 562641112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5078299489 | ||||||||
| FaxNumber: | 5075327295 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MARSHALL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 562582573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5075321024 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2020 | ||||||||
| LastUpdateDate: | 07/17/2020 | ||||||||
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| AuthorizedOfficialLastName: | GUZA | ||||||||
| AuthorizedOfficialFirstName: | ROD | ||||||||
| AuthorizedOfficialMiddleName: | JOHN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5078299489 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | BC-HIS | ||||||||
| NPICertificationDate: | 07/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0700X | N | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech | 237700000X | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.