| Portage Audiology Consultants, LLC | |
|
3850 Glenkerry Ct Portage MI 49024-0700 | |
| (269) 720-7639 | |
| Not Available |
| Full Name | Portage Audiology Consultants, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 3850 Glenkerry Ct, Portage, Michigan |
| Authorized Official Name and Position | Lynette Burkett (OWNER/AUDIOLOGIST) |
| Authorized Official Contact | 2697207639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Portage Audiology Consultants, LLC 3850 Glenkerry Ct Portage MI 49024-0700 Ph: (269) 720-7639 | Portage Audiology Consultants, LLC 3850 Glenkerry Ct Portage MI 49024-0700 Ph: (269) 720-7639 |
| NPI Number | 1609548106 |
|---|---|
| Provider Enumeration Date | 10/02/2021 |
| Last Update Date | 10/12/2021 |
| Certification Date | 10/12/2021 |
| Medicare PECOS PAC ID | 4981092434 |
|---|---|
| Medicare Enrollment ID | O20211102002407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609548106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Lynette Marie Burkett |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1922295732 PECOS PAC ID: 9931384237 Enrollment ID: I20110502000542 |
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