Healthcare Provider Details

I. General information

NPI: 1003803859
Provider Name (Legal Business Name): AUDIO-LOGICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WELLNESS WAY PROFESIONAL BLDG.#1
WASHINGTON PA
15301-9697
US

IV. Provider business mailing address

210 WELLNESS WAY PROFESIONAL BLDG.#1
WASHINGTON PA
15301-9697
US

V. Phone/Fax

Practice location:
  • Phone: 724-228-8212
  • Fax: 724-228-7767
Mailing address:
  • Phone: 724-228-8212
  • Fax: 724-228-7767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT000463L
License Number StatePA

VIII. Authorized Official

Name: MR. RONALD J FECEK
Title or Position: VICE PRESIDENT
Credential: MA,CCC-A
Phone: 724-228-8212