Provider Demographics
NPI:1477830487
Name:INTEGRITY HEARING AND BALANCE LLC
Entity Type:Organization
Organization Name:INTEGRITY HEARING AND BALANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BJARNASON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:801-447-6456
Mailing Address - Street 1:1401 N 1075 W
Mailing Address - Street 2:SUITE 230
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2745
Mailing Address - Country:US
Mailing Address - Phone:801-447-9456
Mailing Address - Fax:801-447-9458
Practice Address - Street 1:1401 N 1075 W
Practice Address - Street 2:SUITE 230
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2745
Practice Address - Country:US
Practice Address - Phone:801-447-9456
Practice Address - Fax:801-447-9458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT55420674101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1336224906Medicaid
UTU000075466Medicare PIN