Provider Demographics
NPI:1144912809
Name:DTB SOUTH, LLC
Entity type:Organization
Organization Name:DTB SOUTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORRINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:LETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-849-8045
Mailing Address - Street 1:39 E 700 S
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2221
Mailing Address - Country:US
Mailing Address - Phone:801-698-3255
Mailing Address - Fax:
Practice Address - Street 1:870 E 9400 S STE 105
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3683
Practice Address - Country:US
Practice Address - Phone:801-849-8045
Practice Address - Fax:801-996-3062
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UTAH MEDICAL HEARING CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-22
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment