| Organization Name: | SOUTHEAST WISCONSIN HEARING, LLC |
| NPI Number: | 1063716165 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIANN KAY DYKSTRA (PRESIDENT) |
| Mailing Address: | 5200 Washington Ave Ste 102 Racine |
| State: | WI US |
| Postal Code: | 534064238 |
| Phone Number: | 2626375668 |
| Fax Number: | 2626375009 |
| NPI Enumeration Date: | 01/04/2011 |
| NPI Last Update Date: | 01/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332S00000X |
| License Number: | 402 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Hearing Aid Equipment |
| Taxonomy Specialization: | |
| Taxonomy Definition: | The manufacture and/or sale of electronic hearing aids, their component parts, and related products and services on a national basis. |