MEDICARE: CARLY ROSE WOHLFEILER AUD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	A.02258	OH

General Provider Information

NPI Number	:	1427738103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY ROSE WOHLFEILER AUD

Provider Business Mailing Address
First Line	:	455 EAGLE TRCE
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-6117
Country	:	US
Telephone Number	:	216-538-3320
Fax Number	:

Provider Business Practice Location Address
First Line	:	5010 MAYFIELD RD STE 116
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2611
Country	:	US
Telephone Number	:	216-273-9362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2023
Last Update Date	:	07/19/2023

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