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General NPI Number Information
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NPI Number | 1356525232
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Entity Type | Organization
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Legal Business Name | MONTEZUMA HEARING CLINIC, INC.
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 892 COTTONWOOD ST STE 2
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City | CORTEZ
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State | CO
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Zip | 81321-2200
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Country | US
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Telephone | 970-565-4655
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Fax | 970-238-2630
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Provider Business Mailing Address
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Address Line | 892 COTTONWOOD ST STE 2
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City | CORTEZ
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State | CO
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Zip | 81321-2200
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Country | US
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Telephone | 970-565-4655
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Fax | 970-238-2630
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY
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Name | DR. LUCIA ANN ARRIOLA-STORY
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Credential | AU.D.
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Telephone | 970-565-4655
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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 | 343
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License Number State | CO
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