Provider Demographics
NPI:1871658427
Name:SOUTHWEST HEARING AND BALANCE
Entity type:Organization
Organization Name:SOUTHWEST HEARING AND BALANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTDOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:OPFER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:417-623-1200
Mailing Address - Street 1:2618 CUNNINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1542
Mailing Address - Country:US
Mailing Address - Phone:417-623-1200
Mailing Address - Fax:417-623-1210
Practice Address - Street 1:2618 CUNNINGHAM AVE
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1542
Practice Address - Country:US
Practice Address - Phone:417-623-1200
Practice Address - Fax:417-623-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO117042332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment