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General NPI Number Information
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NPI Number | 1184953986
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Entity Type | Organization
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Legal Business Name | NEVADA HEARING & BALANCE CENTER LLC
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 2461 W HORIZON RIDGE PKWY SUITE 130
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City | HENDERSON
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State | NV
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Zip | 89052-5943
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Country | US
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Telephone | 702-896-0031
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Fax | 702-896-1044
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Provider Business Mailing Address
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Address Line | 2461 W HORIZON RIDGE PKWY SUITE 130
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City | HENDERSON
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State | NV
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Zip | 89052-5943
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Country | US
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Telephone | 702-896-0031
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Fax | 702-896-1044
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD LAYNE LUEKENGA JR.
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Credential | AU.D.
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Telephone | 435-688-8991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A-187
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License Number State | NV
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