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General NPI Number Information
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NPI Number | 1538441860
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Entity Type | Organization
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Legal Business Name | LANDREAU INC
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 14B PROFESSIONAL CT SW
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City | ROME
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State | GA
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Zip | 30165-2832
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Country | US
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Telephone | 706-234-2001
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Fax |
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Provider Business Mailing Address
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Address Line | 3 CENTRAL PLZ SUITE 215
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City | ROME
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State | GA
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Zip | 30161-3233
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Country | US
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Telephone | 706-234-2001
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Fax | 706-234-2001
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Authorized Official
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Title or Position | PRESIDENT AND CO-OWNER
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Name | MR. CIDNEY SCOTT LANDREAU
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Credential | HIS
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Telephone | 706-234-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | HADS000816
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | HADS000824
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License Number State | GA
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