Provider Demographics
NPI:1942893003
Name:ANIMAS VALLEY AUDIOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:ANIMAS VALLEY AUDIOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDACE
Authorized Official - Middle Name:KAYLA
Authorized Official - Last Name:JEEP
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:970-375-2369
Mailing Address - Street 1:799 E 3RD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5793
Mailing Address - Country:US
Mailing Address - Phone:970-375-2369
Mailing Address - Fax:
Practice Address - Street 1:1280 N MILDRED RD STE 1
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-2212
Practice Address - Country:US
Practice Address - Phone:970-375-2369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANIMAS VALLEY AUDIOLOGY ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty