Provider Demographics
NPI:1902195779
Name:ARIZONA BALANCE AND HEARING ASSOCIATES,LLC
Entity Type:Organization
Organization Name:ARIZONA BALANCE AND HEARING ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:602-265-9000
Mailing Address - Street 1:333 W THOMAS RD
Mailing Address - Street 2:STE 207
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4417
Mailing Address - Country:US
Mailing Address - Phone:602-568-9000
Mailing Address - Fax:602-528-1901
Practice Address - Street 1:333 W THOMAS RD
Practice Address - Street 2:STE 207
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4417
Practice Address - Country:US
Practice Address - Phone:602-568-9000
Practice Address - Fax:602-528-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA7472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ14843Medicaid
AZ14843Medicaid