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Organization

SOUTHWEST HEARING CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN DAVID BRADER BC-HIS (MANAGING MEMBER)
(435) 313-5556
Entity
Organization

Contact information

Practice address
243 E SWALLOWTAIL LN, WASHINGTON, UT 84780-2847
(435) 313-5556
Mailing address
736 S 900 E, SUITE 104, SAINT GEORGE, UT 84790
(435) 767-0240
(435) 215-2535

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
368331-4101
UT
237700000X
Hearing Instrument Specialist
8245946-4601
UT

Other

Enumeration date
12/07/2016
Last updated
09/14/2017
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