Healthcare Provider Details

I. General information

NPI: 1922295740
Provider Name (Legal Business Name): HEALTHY HEARING CENTER OF VIRGINIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2648 VIRGINIA BEACH BLVD STE. A
VIRGINIA BEACH VA
23452-7648
US

IV. Provider business mailing address

2648 VIRGINIA BEACH BLVD STE. A
VIRGINIA BEACH VA
23452-7648
US

V. Phone/Fax

Practice location:
  • Phone: 757-431-1991
  • Fax: 757-431-1887
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number2101001497
License Number StateVA

VIII. Authorized Official

Name: MR. CHRISTOPHER CHARLES MAHER
Title or Position: OWNER/MNGR
Credential: M.ED., BC-HIS
Phone: 757-431-1999