Healthcare Provider Details

I. General information

NPI: 1336113711
Provider Name (Legal Business Name): METRO HEARING SEVICIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13934 N 59TH AVE SUITE 120
GLENDALE AZ
85306-4167
US

IV. Provider business mailing address

13934 N 59TH AVE SUITE 120
GLENDALE AZ
85306-4167
US

V. Phone/Fax

Practice location:
  • Phone: 602-866-0147
  • Fax: 602-547-9644
Mailing address:
  • Phone: 602-866-0147
  • Fax: 602-547-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberDA
License Number StateAZ

VIII. Authorized Official

Name: STEPHEN FRANCIS TEODORO
Title or Position: PRESIDENT
Credential: AUD., CCC-A
Phone: 602-866-0147