Healthcare Provider Details

I. General information

NPI: 1851387286
Provider Name (Legal Business Name): APPALACHIAN STATE UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 UNIVERSITY HALL DRIVE ROOM 120
BOONE NC
28608-2041
US

IV. Provider business mailing address

400 UNIVERSITY HALL DRIVE ROOM 120
BOONE NC
28608-2041
US

V. Phone/Fax

Practice location:
  • Phone: 828-262-2185
  • Fax: 828-262-6766
Mailing address:
  • Phone: 828-262-2185
  • Fax: 828-262-6766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. BRYAN BELCHER
Title or Position: INTERPROFESSIONAL CLINIC DIRECTOR
Credential: MPH
Phone: 828-262-8657