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General NPI Number Information
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NPI Number | 1134200124
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Entity Type | Organization
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Legal Business Name | SIMETRIA
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4040 DUTCHMANS LN # A
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City | LOUISVILLE
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State | KY
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Zip | 40207-4712
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Country | US
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Telephone | 502-895-0404
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Fax | 502-895-0752
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Provider Business Mailing Address
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Address Line | 4040 DUTCHMANS LN # A
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City | LOUISVILLE
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State | KY
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Zip | 40207-4712
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Country | US
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Telephone | 502-895-0404
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Fax | 502-895-0752
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | DANA LYNN DEYOUNG
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Credential |
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Telephone | 502-245-0767
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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 | 0388
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License Number State | KY
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