Provider Demographics
NPI:1578819488
Name:UTAH VALLEY HEARING AND BALANCE LLC
Entity Type:Organization
Organization Name:UTAH VALLEY HEARING AND BALANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MONEY
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:801-655-3118
Mailing Address - Street 1:672 W 400 S
Mailing Address - Street 2:204
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-3157
Mailing Address - Country:US
Mailing Address - Phone:801-655-3118
Mailing Address - Fax:801-704-9441
Practice Address - Street 1:672 W 400 S
Practice Address - Street 2:204
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-3157
Practice Address - Country:US
Practice Address - Phone:801-655-3118
Practice Address - Fax:801-704-9941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-28
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6082321-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
9082OtherPASS CODE