Healthcare Provider Details

I. General information

NPI: 1831773019
Provider Name (Legal Business Name): ALLISON ROOT AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 N CARSON ST
CARSON CITY NV
89706-0153
US

IV. Provider business mailing address

720 ENCANTO DR
SPARKS NV
89441-9204
US

V. Phone/Fax

Practice location:
  • Phone: 775-313-4449
  • Fax:
Mailing address:
  • Phone: 775-313-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA-2967
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: