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General NPI Number Information
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NPI Number | 1174629356
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY ASSOCIATES PROFESSIONAL HEARING SERVICES OF NTH LA, INC.
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 805 STUBBS AVE SUITE C
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City | MONROE
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State | LA
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Zip | 71201-5578
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Country | US
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Telephone | 318-410-8000
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Fax | 318-410-8093
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Provider Business Mailing Address
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Address Line | 805 STUBBS AVE SUITE C
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City | MONROE
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State | LA
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Zip | 71201-5578
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Country | US
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Telephone | 318-410-8000
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Fax | 318-410-8093
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER/PRESIDENT
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Name | DR. LORRA M. PETTIT
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Credential | AU.D.
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Telephone | 318-410-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 3110
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License Number State | LA
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