Healthcare Provider Details

I. General information

NPI: 1255157897
Provider Name (Legal Business Name): MEDICAL HEARING CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 COUNTRY HILLS DR STE 200
OGDEN UT
84403-2511
US

IV. Provider business mailing address

1100 COUNTRY HILLS DR STE 200
OGDEN UT
84403-2511
US

V. Phone/Fax

Practice location:
  • Phone: 801-399-5014
  • Fax: 801-399-0830
Mailing address:
  • Phone: 801-399-5014
  • Fax: 801-399-0830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. KODY KENNINGTON
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 801-399-5014