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General NPI Number Information
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NPI Number | 1295106516
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Entity Type | Organization
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Legal Business Name | MIAMI VALLEY HEARING AND BALANCE, LLC
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 4720 WILMINGTON PIKE
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City | KETTERING
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State | OH
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Zip | 45440-2021
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Country | US
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Telephone | 937-435-5033
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Fax | 937-435-5512
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Provider Business Mailing Address
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Address Line | 4720 WILMINGTON PIKE
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City | KETTERING
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State | OH
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Zip | 45440-2021
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Country | US
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Telephone | 937-435-5033
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Fax | 937-435-5512
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Authorized Official
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Title or Position | SOLE BUSINESS OWNER
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Name | LYNN CARPENTER
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Credential | AUD
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Telephone | 937-435-5033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A-1009
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License Number State | OH
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