Basic Information
| Provider Information | |||||||||
| NPI: | 1215238068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEYERS | ||||||||
| FirstName: | JARED | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | AUD. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2222 E. HIGHLAND AVE | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022574219 | ||||||||
| FaxNumber: | 6022578319 | ||||||||
| Practice Location | |||||||||
| Address1: | 1520 S. DOBSON RD | ||||||||
| Address2: | SUITE 305 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805394000 | ||||||||
| FaxNumber: | 4808333040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2010 | ||||||||
| LastUpdateDate: | 03/18/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | DA6997 | AZ | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.