Provider Demographics
NPI:1083841829
Name:PROFESSIONAL HEARING SERVICES CORP.
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING SERVICES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:303-237-4967
Mailing Address - Street 1:2405 WADSWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-5713
Mailing Address - Country:US
Mailing Address - Phone:303-237-4967
Mailing Address - Fax:303-237-4966
Practice Address - Street 1:2405 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-5713
Practice Address - Country:US
Practice Address - Phone:303-237-4967
Practice Address - Fax:303-237-4966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty