Provider Demographics
NPI:1649693805
Name:ROBE, JEFF (HIS)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:ROBE
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8941 S 700 E
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-2400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8941 S 700 E
Practice Address - Street 2:SUITE 204
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2400
Practice Address - Country:US
Practice Address - Phone:801-849-8497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5505767-4602237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist