Provider Demographics
NPI:1891809364
Name:HEARING AND BALANCE CENTER, LLC
Entity Type:Organization
Organization Name:HEARING AND BALANCE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEABORG
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:704-542-3339
Mailing Address - Street 1:3601 CARMEL FOREST DR.
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-8115
Mailing Address - Country:US
Mailing Address - Phone:704-542-3339
Mailing Address - Fax:704-846-2911
Practice Address - Street 1:3601 CARMEL FOREST DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8115
Practice Address - Country:US
Practice Address - Phone:704-846-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC135WXOtherBCBS
NC7412893Medicaid