Provider Demographics
NPI:1851618821
Name:DESERT VALLEY AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:DESERT VALLEY AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HUNSAKER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:702-605-9133
Mailing Address - Street 1:2911 N TENAYA WAY STE 205
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0495
Mailing Address - Country:US
Mailing Address - Phone:702-605-9133
Mailing Address - Fax:702-678-6159
Practice Address - Street 1:501 S RANCHO DR STE A8
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4871
Practice Address - Country:US
Practice Address - Phone:702-605-9133
Practice Address - Fax:702-678-6159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit