Healthcare Provider Details

I. General information

NPI: 1841844800
Provider Name (Legal Business Name): NATIONAL HEARING AND BALANCE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6709 ACADEMY RD NE STE B
ALBUQUERQUE NM
87109-3363
US

IV. Provider business mailing address

PO BOX 15042
RIO RANCHO NM
87174-0042
US

V. Phone/Fax

Practice location:
  • Phone: 505-217-0912
  • Fax: 505-217-0913
Mailing address:
  • Phone: 505-207-7550
  • Fax: 505-207-7559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MR. BRAD ROGERS
Title or Position: OWNER
Credential:
Phone: 505-715-3710