Provider Demographics
NPI:1740489277
Name:UPPER VALLEY HEARING & BALANCE INC
Entity type:Organization
Organization Name:UPPER VALLEY HEARING & BALANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:HUNTER
Authorized Official - Last Name:RUDY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:937-308-7000
Mailing Address - Street 1:3130 N DIXIE HWY
Mailing Address - Street 2:AUDIOLOGY SUITE #1430
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1337
Mailing Address - Country:US
Mailing Address - Phone:937-308-7000
Mailing Address - Fax:937-440-4396
Practice Address - Street 1:3130 N DIXIE HWY
Practice Address - Street 2:AUDIOLOGY SUITE #1430
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1337
Practice Address - Country:US
Practice Address - Phone:937-308-7000
Practice Address - Fax:937-440-4396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-14
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00421237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0754296Medicaid
OH0754296Medicaid