Provider Demographics
NPI:1982025201
Name:ADVANCED HEARING AND BALANCE LLC
Entity Type:Organization
Organization Name:ADVANCED HEARING AND BALANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-687-4755
Mailing Address - Street 1:5128 OLD HIGHWAY 11 STE 8
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-6234
Mailing Address - Country:US
Mailing Address - Phone:601-450-0280
Mailing Address - Fax:
Practice Address - Street 1:5128 OLD HIGHWAY 11 STE 8
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-6234
Practice Address - Country:US
Practice Address - Phone:601-450-0280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-05
Last Update Date:2014-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA3381231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty