Healthcare Provider Details

I. General information

NPI: 1851392849
Provider Name (Legal Business Name): AMERICAN INSTITUTE OF BALANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 BRYAN DAIRY RD SUITE 340
LARGO FL
33777-1363
US

IV. Provider business mailing address

8200 BRYAN DAIRY RD SUITE 340
LARGO FL
33777-1363
US

V. Phone/Fax

Practice location:
  • Phone: 727-398-5728
  • Fax: 727-398-4914
Mailing address:
  • Phone: 727-398-5728
  • Fax: 727-398-4914

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: RICHARD E GANS
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 727-398-5728