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General NPI Number Information
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NPI Number | 1730954553
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Entity Type | Organization
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Legal Business Name | UPPER VALLEY AUDIOLOGY LLC
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 256 N 2ND E STE 3
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City | REXBURG
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State | ID
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Zip | 83440-1638
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Country | US
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Telephone | 208-497-0134
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Fax | 208-710-8986
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Provider Business Mailing Address
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Address Line | 256 N 2ND E STE 3
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City | REXBURG
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State | ID
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Zip | 83440-1638
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Country | US
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Telephone | 208-497-0134
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Fax | 208-710-8986
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | TRAVIS ROSS RIGBY
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Credential | AU.D.
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Telephone | 208-569-6207
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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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