Healthcare Provider Details

I. General information

NPI: 1124363528
Provider Name (Legal Business Name): YAVAPAI HEARING AID CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8560 HIGHWAY 69 #A
PRESCOTT VALLEY AZ
86314
US

IV. Provider business mailing address

8560 HIGHWAY 69 #A
PRESCOTT VALLEY AZ
86314
US

V. Phone/Fax

Practice location:
  • Phone: 928-445-7710
  • Fax: 928-445-7715
Mailing address:
  • Phone: 928-445-7710
  • Fax: 928-445-7715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number332S00000X
License Number StateAZ

VIII. Authorized Official

Name: MS. DEE ANN PRINZ
Title or Position: OWNER
Credential:
Phone: 928-445-7710