Provider Demographics
NPI:1215156369
Name:MANUEL, RICHARD D (HIS HEARING INSTRUME)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:D
Last Name:MANUEL
Suffix:
Gender:M
Credentials:HIS HEARING INSTRUME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S LA CANADA DR
Mailing Address - Street 2:SUITE 72
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-2603
Mailing Address - Country:US
Mailing Address - Phone:520-399-3220
Mailing Address - Fax:520-399-2233
Practice Address - Street 1:101 S LA CANADA DR
Practice Address - Street 2:SUITE 72
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-2603
Practice Address - Country:US
Practice Address - Phone:520-399-3220
Practice Address - Fax:520-399-2233
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02335237600000X
AZHAD6218237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter