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General NPI Number Information
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NPI Number | 1447502968
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Entity Type | Organization
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Legal Business Name | ADVANCED AUDIOLOGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 10/08/2012
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Provider Practice Location Address
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Address Line | 10503 W THUNDERBIRD BLVD SUITE 114
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City | SUN CITY
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State | AZ
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Zip | 85351-3022
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Country | US
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Telephone | 623-825-0999
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Fax | 623-875-6632
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Provider Business Mailing Address
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Address Line | 10503 W THUNDERBIRD BLVD SUITE 114
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City | SUN CITY
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State | AZ
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Zip | 85351-3022
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Country | US
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Telephone | 623-825-0999
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Fax | 623-875-6632
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Authorized Official
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Title or Position | OWNER MANAGER
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Name | DR. GREGORY ROBERT MOORE
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Credential | AU.D.
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Telephone | 623-825-0999
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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 | DA852
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License Number State | AZ
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