Healthcare Provider Details
I. General information
NPI: 1861967234
Provider Name (Legal Business Name): NORA A.C. MARTIN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/11/2018
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
317 S. ORANGE ST
MISSOULA MT
59801
US
IV. Provider business mailing address
317 S. ORANGE ST
MISSOULA MT
59801
US
V. Phone/Fax
- Phone: 406-549-1951
- Fax: 406-542-5682
- Phone: 406-549-1951
- Fax: 406-542-5682
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | SLP-AU-LIC-9129 |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | SLP-AU-LIC9129 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: