Healthcare Provider Details
I. General information
NPI: 1609979087
Provider Name (Legal Business Name): AUDIOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2006
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
214 E ELM SUITE 111
MONROE MI
48162-2678
US
IV. Provider business mailing address
214 E ELM SUITE 111
MONROE MI
48161-7085
US
V. Phone/Fax
- Phone: 734-241-4080
- Fax: 734-241-4798
- Phone: 734-241-4080
- Fax: 734-241-4798
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
J
HENRY
JR.
Title or Position: OWNER
Credential: AUD
Phone: 734-241-4080