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General NPI Number Information
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NPI Number | 1740494897
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Entity Type | Organization
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Legal Business Name | AMERICAN HEARING CARE REGIONAL HEARING AND BALANCE CENTER CORP
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3345 MERLIN DR STE 200
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7405
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Country | US
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Telephone | 208-529-1514
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Fax | 208-529-3170
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Provider Business Mailing Address
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Address Line | 3345 MERLIN DR STE 200
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7405
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Country | US
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Telephone | 208-529-1514
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Fax | 208-529-3170
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Authorized Official
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Title or Position | MANAGING AUDIOLOGIST
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Name | MR. ZACKARY HALE
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Credential | AU.D.
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Telephone | 208-529-1514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231HA2500X
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Taxonomy Name | Assistive Technology Supplier Audiologist
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License Number |
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License Number State | ID
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