Healthcare Provider Details

I. General information

NPI: 1831144344
Provider Name (Legal Business Name): DENISE FREE LENSGRAF-LANDERS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: DENISE FREE LENSGRAF AU.D.

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAVHCS AUDIOLOGY (117) 2400 HOSPITAL ROAD
TUSKEGEE AL
36083
US

IV. Provider business mailing address

609 SCOTTWOODS DR
AUBURN AL
36830-5219
US

V. Phone/Fax

Practice location:
  • Phone: 334-725-3060
  • Fax: 334-725-3226
Mailing address:
  • Phone: 334-725-3060
  • Fax: 334-725-3226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number980A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: