Provider Demographics
NPI:1346586468
Name:A.T. STILL UNIVERSITY OF HEALTH SCIENCES
Entity Type:Organization
Organization Name:A.T. STILL UNIVERSITY OF HEALTH SCIENCES
Other - Org Name:THE AFA BALANCE & HEARING INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:480-265-8067
Mailing Address - Street 1:4838 E BASELINE RD STE 126
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4673
Mailing Address - Country:US
Mailing Address - Phone:480-265-8067
Mailing Address - Fax:480-656-6316
Practice Address - Street 1:4838 E BASELINE RD STE 126
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4673
Practice Address - Country:US
Practice Address - Phone:480-265-8067
Practice Address - Fax:480-656-6316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA6015231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty