Healthcare Provider Details

I. General information

NPI: 1629600655
Provider Name (Legal Business Name): HEARING HEALTH AZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6424 E GREENWAY PKWY
SCOTTSDALE AZ
85254-2045
US

IV. Provider business mailing address

6424 E GREENWAY PKWY
SCOTTSDALE AZ
85254-2045
US

V. Phone/Fax

Practice location:
  • Phone: 480-862-4327
  • Fax: 480-256-1010
Mailing address:
  • Phone: 480-862-4327
  • Fax: 480-256-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RYAN CONKLIN
Title or Position: OWNER
Credential: HAD
Phone: 480-862-4327