Healthcare Provider Details
I. General information
NPI: 1205801479
Provider Name (Legal Business Name): FALLS PLAZA HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2006
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
319 FALLS DR NW
ABINGDON VA
24210-8093
US
IV. Provider business mailing address
319 FALLS DR NW
ABINGDON VA
24210-8093
US
V. Phone/Fax
- Phone: 276-676-1111
- Fax: 276-676-1112
- Phone: 276-676-1111
- Fax: 276-676-1112
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | 2201000678 |
| License Number State | VA |
VIII. Authorized Official
Name: MR.
MICHAEL
RONALD
VALENZA
Title or Position: PRESIDENT
Credential: M.S.
Phone: 276-676-1111