MEDICARE: BRANT AUDIOLOGY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	231HA2400X	Assistive Technology Practitioner Audiologist
2	231HA2500X	Assistive Technology Supplier Audiologist
3	2355A2700X	Audiology Assistant
4	237600000X	Audiologist-Hearing Aid Fitter
5	237700000X	Hearing Instrument Specialist
6	332S00000X	Hearing Aid Equipment
7	231H00000X	Audiologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417123019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANT AUDIOLOGY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 21804
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82003-7073
Country	:	US
Telephone Number	:	307-426-4327
Fax Number	:	307-426-3277

Provider Business Practice Location Address
First Line	:	7215 COMMONS CIR UNIT C
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82009-2666
Country	:	US
Telephone Number	:	307-426-4327
Fax Number	:	307-426-3277

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRANT R CHRISTENSEN
Credential	:	AU.D.
Telephone Number	:	307-426-4327

Provider Enumeration Date	:	05/02/2008
Last Update Date	:	10/16/2020

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Directions to “BRANT AUDIOLOGY, LLC ” Practice Location

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