Healthcare Provider Details
I. General information
NPI: 1265637672
Provider Name (Legal Business Name): AUDIOLOGY ASSOCIATES HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2007
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 MARGARET LN SUITE D
GRASS VALLEY CA
95945-4207
US
IV. Provider business mailing address
101 MARGARET LN SUITE D
GRASS VALLEY CA
95945-4207
US
V. Phone/Fax
- Phone: 530-272-2247
- Fax: 530-272-4120
- Phone: 530-272-2247
- Fax: 530-272-4120
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | AU305 |
| License Number State | CA |
VIII. Authorized Official
Name:
KAREN
COLEY
BRIDGER
Title or Position: AUDIOLOGIST
Credential: M.A.
Phone: 530-272-2247