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General NPI Number Information
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NPI Number | 1063471597
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Entity Type | Organization
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Legal Business Name | SALINE AUDIOLOGY ASSOCIATES, LLC.
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 5 MEDICAL PARK DR STE 101
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City | BENTON
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State | AR
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Zip | 72015-3729
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Country | US
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Telephone | 501-778-3868
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Fax | 501-317-1704
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Provider Business Mailing Address
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Address Line | 5 MEDICAL PARK DR STE 101
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City | BENTON
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State | AR
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Zip | 72015-3729
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Country | US
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Telephone | 501-778-3868
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Fax | 501-317-1704
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LISA C RICHEY
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Credential | AU.D.
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Telephone | 501-778-3868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | A#77
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License Number State | AR
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