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General NPI Number Information
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NPI Number | 1619239092
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Entity Type | Organization
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Legal Business Name | KENNINGTON HEARING & BALANCE CENTER
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Dates
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Enumeration Date | 06/12/2012
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 1100 COUNTRY HILLS DR 200
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City | OGDEN
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State | UT
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Zip | 84403-2503
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Country | US
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Telephone | 801-399-5014
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Fax |
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Provider Business Mailing Address
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Address Line | 985 W 7850 S
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City | WILLARD
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State | UT
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Zip | 84340-6701
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Country | US
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Telephone | 801-643-7088
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Fax |
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Authorized Official
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Title or Position | DR. OF AUDIOLOGY
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Name | MR. KODY D KENNINGTON
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Credential | AU.D.
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Telephone | 801-643-7088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #2
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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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