Healthcare Provider Details

I. General information

NPI: 1992193734
Provider Name (Legal Business Name): VCV HEARING LABS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2015
Last Update Date: 01/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 S ORANGE AVE
ORLANDO FL
32806-2116
US

IV. Provider business mailing address

1234 E AIRPORT RD
SAFFORD AZ
85546-9147
US

V. Phone/Fax

Practice location:
  • Phone: 407-286-0417
  • Fax: 407-286-0417
Mailing address:
  • Phone: 928-965-0050
  • Fax: 888-399-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: DAVID CLUFF
Title or Position: OWNER
Credential:
Phone: 928-965-0050