Provider Demographics
NPI:1215961644
Name:BALANCE AND EAR CENTER, INC
Entity type:Organization
Organization Name:BALANCE AND EAR CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SHAIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-288-3277
Mailing Address - Street 1:10200 THREE CHOPT RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233
Mailing Address - Country:US
Mailing Address - Phone:804-288-3277
Mailing Address - Fax:804-282-1043
Practice Address - Street 1:10200 THREE CHOPT RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233
Practice Address - Country:US
Practice Address - Phone:804-288-3277
Practice Address - Fax:804-282-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101017492174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty