Basic Information
| Provider Information | |||||||||
| NPI: | 1306181904 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | REBER | ||||||||
| FirstName: | KEITH | ||||||||
| MiddleName: | A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 140 S 200 W | ||||||||
| Address2: | |||||||||
| City: | SPRINGVILLE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846631817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014726154 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4778 N 300 W STE 220 | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846047710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013412193 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2012 | ||||||||
| LastUpdateDate: | 04/02/2015 | ||||||||
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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 | 237700000X | 310421-4601 | UT | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.