Provider Demographics
NPI:1144569591
Name:MIAMI VALLEY HEARING & BALANCE
Entity Type:Organization
Organization Name:MIAMI VALLEY HEARING & BALANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:FLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:937-435-5033
Mailing Address - Street 1:4720 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440-2021
Mailing Address - Country:US
Mailing Address - Phone:937-435-5033
Mailing Address - Fax:
Practice Address - Street 1:4720 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45440-2021
Practice Address - Country:US
Practice Address - Phone:937-435-5033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty