Healthcare Provider Details

I. General information

NPI: 1013156074
Provider Name (Legal Business Name): ASHLEY ANDERSON AUD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2009
Last Update Date: 02/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 14TH AVE SW SUITE 100
SIDNEY MT
59270-3521
US

IV. Provider business mailing address

214 14TH AVE SW SUITE 100
SIDNEY MT
59270-3521
US

V. Phone/Fax

Practice location:
  • Phone: 406-488-2184
  • Fax:
Mailing address:
  • Phone: 406-488-2184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1184
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number379
License Number StateMT

VIII. Authorized Official

Name: CHRISTIE DELANEY
Title or Position: PFS DIRECTOR
Credential:
Phone: 406-488-2102