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General NPI Number Information
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NPI Number | 1407183981
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Entity Type | Organization
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Legal Business Name | AMY K. ROTHERMEL AU.D. LLC
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 121 S CHINA LAKE BLVD STE B
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City | RIDGECREST
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State | CA
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Zip | 93555-4049
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Country | US
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Telephone | 760-375-9399
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Fax | 760-375-9499
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Provider Business Mailing Address
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Address Line | 121 S CHINA LAKE BLVD STE B
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City | RIDGECREST
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State | CA
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Zip | 93555-4049
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Country | US
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Telephone | 760-375-9399
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Fax | 760-375-9499
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. AMY KATHERINE ROTHERMEL
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Credential | AU.D.
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Telephone | 760-375-9399
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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 | AU2288
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License Number State | CA
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