Tri State Audiology & Vestibular Center

Primary specialty

Hearing Aid EquipmentTaxonomy code 332S00000X

License

DA4586 Issued in AZ

Legal business name

TRI STATE AUDIOLOGY & VESTIBULAR CENTER

Practice address

1677 Quartz Cir
Bullhead City, AZ 86442-6016

Phone

(928) 758-9130

Fax

(928) 758-4404

NPI assigned

May 16, 2008

Last updated

May 16, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Larry Dale Waters, AUD

Title

Owner

Phone

(928) 758-3337

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1801053046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 RAMAR RD",
            "address_2": "SUIE D",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427117",
            "telephone_number": "928-758-3337",
            "fax_number": "928-758-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 QUARTZ CIR",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864426016",
            "telephone_number": "928-758-9130",
            "fax_number": "928-758-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE AUDIOLOGY & VESTIBULAR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-758-3337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "AZ",
            "license": "DA4586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Judith L Trevisano, AGNP
• Tri State Anesthesia Associates PLC
• Tri State Gastroenterology, P.C.
• Tri-State OB-GYN PC
• Tri-State Orthopedic Institute, P.C.
• Tri-State Physical Therapy Services Inc (Physical Therapy Services)
• Tri-State Radiation Oncology, Inc.

• Hearing Aid Equipment in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Hearing Aid Equipment in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.