Healthcare Provider Details
I. General information
NPI: 1992834709
Provider Name (Legal Business Name): ARCHES AUDIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16 S 100 E
MOAB UT
84532-2638
US
IV. Provider business mailing address
16 S 100 E
MOAB UT
84532-2638
US
V. Phone/Fax
- Phone: 435-259-2508
- Fax: 435-259-2513
- Phone: 435-259-2508
- Fax: 435-259-2513
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 61008144101 |
| License Number State | UT |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
DAVID
WARD
Title or Position: OWNER
Credential: AUD
Phone: 435-259-2508