Healthcare Provider Details

I. General information

NPI: 1871658427
Provider Name (Legal Business Name): SOUTHWEST HEARING AND BALANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2618 CUNNINGHAM AVE
JOPLIN MO
64804-1542
US

IV. Provider business mailing address

2618 CUNNINGHAM AVE
JOPLIN MO
64804-1542
US

V. Phone/Fax

Practice location:
  • Phone: 417-623-1200
  • Fax: 417-623-1210
Mailing address:
  • Phone: 417-623-1200
  • Fax: 417-623-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number117042
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number117042
License Number StateMO

VIII. Authorized Official

Name: DR. DANA MARIE OPFER
Title or Position: PRESIDENTDOCTOR OF AUDIOLOGY
Credential: AU.D.
Phone: 417-623-1200