Provider Demographics
NPI:1730954553
Name:UPPER VALLEY AUDIOLOGY LLC
Entity type:Organization
Organization Name:UPPER VALLEY AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:RIGBY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:208-569-6207
Mailing Address - Street 1:256 N 2ND E STE 3
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-1638
Mailing Address - Country:US
Mailing Address - Phone:208-497-0134
Mailing Address - Fax:208-710-8986
Practice Address - Street 1:256 N 2ND E STE 3
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-1638
Practice Address - Country:US
Practice Address - Phone:208-497-0134
Practice Address - Fax:208-710-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty