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General NPI Number Information
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NPI Number | 1811493349
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Entity Type | Organization
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Legal Business Name | HEROES OF HEARING, LLC
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 3275 W INA RD STE 117
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City | TUCSON
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State | AZ
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Zip | 85741-2330
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Country | US
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Telephone | 520-230-3999
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Fax | 888-240-3305
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Provider Business Mailing Address
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Address Line | 3275 W INA RD STE 117
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City | TUCSON
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State | AZ
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Zip | 85741-2330
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Country | US
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Telephone | 520-230-3999
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Fax | 888-240-3305
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Authorized Official
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Title or Position | OWNER
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Name | RUSSELL LEE BROADHEAD
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Credential | HIS
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Telephone | 520-230-3999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | BHAD11141
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License Number State | AZ
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