Healthcare Provider Details

I. General information

NPI: 1578925376
Provider Name (Legal Business Name): NEW HORIZONS HEARING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1471 DEWAR DR STE 143
ROCK SPRINGS WY
82901-5815
US

IV. Provider business mailing address

6576 S 1615 E
MURRAY UT
84121-2521
US

V. Phone/Fax

Practice location:
  • Phone: 307-632-2662
  • Fax:
Mailing address:
  • Phone: 801-631-8436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number152
License Number StateWY

VIII. Authorized Official

Name: BLAKE JAMES WEBB
Title or Position: PRESIDENT
Credential: BCHIS
Phone: 801-631-8436