Provider Demographics
NPI:1417277484
Name:HEARING AND BALANCE INSTITUTE OF THE ROCKIES, INC.
Entity Type:Organization
Organization Name:HEARING AND BALANCE INSTITUTE OF THE ROCKIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:EVELYN
Authorized Official - Last Name:IVES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:303-993-8832
Mailing Address - Street 1:9695 S YOSEMITE ST
Mailing Address - Street 2:SUITE 356
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2888
Mailing Address - Country:US
Mailing Address - Phone:303-993-8832
Mailing Address - Fax:303-954-8316
Practice Address - Street 1:9695 S YOSEMITE ST
Practice Address - Street 2:SUITE 356
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2888
Practice Address - Country:US
Practice Address - Phone:303-993-8832
Practice Address - Fax:303-954-8316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO559237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO77034261Medicaid
CO77034261Medicaid