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General NPI Number Information
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NPI Number | 1477939718
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Entity Type | Organization
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Legal Business Name | RIVER VALLEY AUDIOLOGY LLC
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 215 N 2ND ST SUITE 101
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City | RIVER FALLS
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State | WI
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Zip | 54022-3706
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Country | US
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Telephone | 715-245-0525
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Fax |
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Provider Business Mailing Address
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Address Line | 215 N 2ND ST SUITE 101
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City | RIVER FALLS
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State | WI
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Zip | 54022-3706
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Country | US
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Telephone | 715-245-0525
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Fax |
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Authorized Official
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Title or Position | OWNER/AUDIOLOGIST
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Name | MR. DAVID JOHN BEUTEL
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Credential | MA
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Telephone | 71524505205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 197-156
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License Number State | WI
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