Provider Demographics
NPI:1770716979
Name:JORDAN HEARING AND BALANCE LLC
Entity type:Organization
Organization Name:JORDAN HEARING AND BALANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ALVORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-344-9495
Mailing Address - Street 1:10588 S REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8503
Mailing Address - Country:US
Mailing Address - Phone:801-344-9495
Mailing Address - Fax:
Practice Address - Street 1:10588 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8503
Practice Address - Country:US
Practice Address - Phone:801-344-9495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty