Provider Demographics
NPI:1023718814
Name:MOORE MOUNTAIN HEARING LLC.
Entity type:Organization
Organization Name:MOORE MOUNTAIN HEARING LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:970-485-6802
Mailing Address - Street 1:100 SHANE CT
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:CO
Mailing Address - Zip Code:80435-8517
Mailing Address - Country:US
Mailing Address - Phone:970-485-6802
Mailing Address - Fax:970-829-4410
Practice Address - Street 1:301 WEST MAIN STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-485-6802
Practice Address - Fax:970-829-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty