Healthcare Provider Details

I. General information

NPI: 1093907693
Provider Name (Legal Business Name): ROCKY MOUNTAIN HEARING & BALANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5872 S 900 E STE 175
SALT LAKE CITY UT
84121
US

IV. Provider business mailing address

5872 S 900 E STE 175
MURRAY UT
84121-1673
US

V. Phone/Fax

Practice location:
  • Phone: 801-268-3277
  • Fax: 801-268-3288
Mailing address:
  • Phone: 801-268-3277
  • Fax: 801-268-3288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number108348-4101
License Number StateUT

VIII. Authorized Official

Name: MELANIE PACE
Title or Position: OFFICE MANAGER
Credential:
Phone: 801-268-3277