Healthcare Provider Details

I. General information

NPI: 1255523437
Provider Name (Legal Business Name): LEROY INVESTMENTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8806 S REDWOOD RD SUITE 103
WEST JORDAN UT
84088-9337
US

IV. Provider business mailing address

8806 S REDWOOD RD SUITE 103
WEST JORDAN UT
84088-9337
US

V. Phone/Fax

Practice location:
  • Phone: 801-495-4800
  • Fax: 801-495-4803
Mailing address:
  • Phone: 801-495-4800
  • Fax: 801-495-4803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3088514101
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4830696-4601
License Number StateUT

VIII. Authorized Official

Name: MRS. MOLLY MALISSA LEROY
Title or Position: OWNER
Credential: BC-HIS
Phone: 801-495-4800