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General NPI Number Information
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NPI Number | 1245333624
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Entity Type | Organization
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Legal Business Name | RIVERSIDE HEARING SERVICES
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 14600 KING RD SUITE D
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City | RIVERVIEW
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State | MI
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Zip | 48193-7952
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Country | US
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Telephone | 734-486-4444
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Fax | 734-486-5555
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Provider Business Mailing Address
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Address Line | 14600 KING RD SUITE D
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City | RIVERVIEW
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State | MI
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Zip | 48193-7952
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Country | US
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Telephone | 734-486-4444
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Fax | 734-486-5555
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Authorized Official
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Title or Position | OWNER
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Name | LAURIE S NASTAS
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Credential |
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Telephone | 734-486-4444
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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 |
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License Number State |
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