Provider Demographics
NPI:1245568898
Name:AT HOME HEARING
Entity Type:Organization
Organization Name:AT HOME HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-755-3962
Mailing Address - Street 1:697 W 810 N
Mailing Address - Street 2:
Mailing Address - City:WEST BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84087-1291
Mailing Address - Country:US
Mailing Address - Phone:801-755-3968
Mailing Address - Fax:
Practice Address - Street 1:697 W 810 N
Practice Address - Street 2:
Practice Address - City:WEST BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84087-1291
Practice Address - Country:US
Practice Address - Phone:801-755-3968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT352082-4601332S00000X
UT6773094-4602332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment