Provider Demographics
NPI:1659761062
Name:APPALACHIAN HEARING AND SPEECH CENTER, LLC
Entity Type:Organization
Organization Name:APPALACHIAN HEARING AND SPEECH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:AU D
Authorized Official - Phone:423-914-2846
Mailing Address - Street 1:306 SUNSET DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2492
Mailing Address - Country:US
Mailing Address - Phone:423-328-9190
Mailing Address - Fax:423-328-9189
Practice Address - Street 1:306 SUNSET DR
Practice Address - Street 2:SUITE 103
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2492
Practice Address - Country:US
Practice Address - Phone:423-328-9190
Practice Address - Fax:423-328-9189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-24
Last Update Date:2015-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1468231H00000X
TN247231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty