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General NPI Number Information
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NPI Number | 1033415765
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Entity Type | Organization
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Legal Business Name | NORDSTAR AUDIOLOGY II
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 417 HILL RD N
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City | PICKERINGTON
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State | OH
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Zip | 43147-1310
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Country | US
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Telephone | 614-834-4364
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Fax | 614-834-4368
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Provider Business Mailing Address
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Address Line | 417 HILL RD N
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City | PICKERINGTON
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State | OH
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Zip | 43147-1310
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Country | US
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Telephone | 614-834-4364
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Fax | 614-834-4368
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | COLLEEN EVANS
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Credential |
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Telephone | 614-834-4364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A-01076
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 02818
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License Number State | OH
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