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General NPI Number Information
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NPI Number | 1790958924
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Entity Type | Organization
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Legal Business Name | VALLEYDALE HEARING & BALANCE CENTER
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 250 INVERNESS CENTER DR. SUITE C
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City | BIRMINGHAM
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State | AL
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Zip | 35242
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Country | US
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Telephone | 205-936-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 250 INVERNESS CENTER DR. SUITE C
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City | BIRMINGHAM
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State | AL
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Zip | 35242
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Country | US
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Telephone | 205-936-3001
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. ROBERT DICK MCCLUNG
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Credential | AU.D.
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Telephone | 205-936-3001
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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 | 672A
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License Number State | AL
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