| Organization Name: | K KINIFICK ENT LLC |
| NPI Number: | 1891074191 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KURT KINIFICK (OWN/MGR) |
| Mailing Address: | 6600 Menaul Blvd Ne Ste 700 (inside Sears) Miracle Ear Hearing Albuquerque |
| State: | NM US |
| Postal Code: | 87110 |
| Phone Number: | 5058808898 |
| Fax Number: | 5058814952 |
| NPI Enumeration Date: | 08/04/2011 |
| NPI Last Update Date: | 08/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332S00000X |
| License Number: | 03-221541-00-0 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| 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. |