Healthcare Provider Details

I. General information

NPI: 1366655946
Provider Name (Legal Business Name): KOVAL HEARING VENTURES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 E FILLMORE ST
COLORADO SPRINGS CO
80907-6380
US

IV. Provider business mailing address

941 E FILLMORE ST
COLORADO SPRINGS CO
80907-6380
US

V. Phone/Fax

Practice location:
  • Phone: 719-520-9099
  • Fax: 719-634-2859
Mailing address:
  • Phone: 719-520-9099
  • Fax: 719-634-2859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number204
License Number StateCO

VIII. Authorized Official

Name: MR. ERIC THOMAS KOVAL
Title or Position: OWNER
Credential: NBC-HIS
Phone: 281-337-8090