Healthcare Provider Details

I. General information

NPI: 1609887421
Provider Name (Legal Business Name): MARY KELLY BONE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST AUDIOLOGY (126)
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

1023 TAYLOR AVE
BELLEVUE KY
41073-1640
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number894A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: