Healthcare Provider Details

I. General information

NPI: 1104551712
Provider Name (Legal Business Name): AUDIOLOGY CONCEPTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 MATTERHORN DR
DULUTH MN
55811-3851
US

IV. Provider business mailing address

7380 FRANCE AVE S STE 200
EDINA MN
55435-4506
US

V. Phone/Fax

Practice location:
  • Phone: 218-723-7880
  • Fax: 218-723-8208
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: KARRI KIEFAT
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 218-723-7880