Healthcare Provider Details

I. General information

NPI: 1477601482
Provider Name (Legal Business Name): ROANOKE VALLEY SPEECH AND HEARING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 COLONIAL AVE SW
ROANOKE VA
24015-3204
US

IV. Provider business mailing address

2030 COLONIAL AVE SW
ROANOKE VA
24015-3204
US

V. Phone/Fax

Practice location:
  • Phone: 540-343-0165
  • Fax: 540-345-4664
Mailing address:
  • Phone: 540-343-0165
  • Fax: 540-345-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number2101 001445
License Number StateVA

VIII. Authorized Official

Name: MS. J. ANDREE' BROOKS
Title or Position: PRESIDENT
Credential:
Phone: 540-343-0165