Healthcare Provider Details
I. General information
NPI: 1467894469
Provider Name (Legal Business Name): HEARING REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2013
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2980 GINNALA DR UNIT 102
LOVELAND CO
80538-2825
US
IV. Provider business mailing address
8321 SANGRE DE CRISTO RD STE 202
LITTLETON CO
80127-6425
US
V. Phone/Fax
- Phone: 970-593-9700
- Fax: 970-593-9712
- Phone: 303-984-4414
- Fax: 303-984-6244
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | CO |
VIII. Authorized Official
Name:
MATTHEW
A
WILKEN
Title or Position: VICE PRESIDENT
Credential: AUD
Phone: 303-984-4414