Healthcare Provider Details

I. General information

NPI: 1063754398
Provider Name (Legal Business Name): LION HEARING CENTERS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E 3300 S SUITE 102
SALT LAKE CITY UT
84106-2184
US

IV. Provider business mailing address

2208 HIGHWAY 121 SUITE 180
BEDFORD TX
76021-5981
US

V. Phone/Fax

Practice location:
  • Phone: 801-466-5929
  • Fax: 801-466-2154
Mailing address:
  • Phone: 817-268-8103
  • Fax: 817-282-5967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4988314-4602
License Number StateUT

VIII. Authorized Official

Name: NATHAN LEE
Title or Position: PRESIDENT
Credential:
Phone: 817-268-8103