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Organization

RIVERSIDE HEARING SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURIE S NASTAS (OWNER)
(734) 486-4444
Entity
Organization

Contact information

Practice address
14600 KING RD, SUITE D, RIVERVIEW, MI 48193-7952
(734) 486-4444
(734) 486-5555
Mailing address
14600 KING RD, SUITE D, RIVERVIEW, MI 48193-7952
(734) 486-4444
(734) 486-5555

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4189127
MI
01
5352130
AETNA HMO & MC
01
540H218800
BCBSM
MI
01
640H218730
BCBSM
MI
Enumeration date
09/07/2006
Last updated
01/07/2009
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