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General NPI Number Information
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NPI Number | 1710070974
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Entity Type | Organization
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Legal Business Name | CHARLOTTE AUDIOLOGY SERVICES
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1928 RANDOLPH RD STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28207-1105
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Country | US
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Telephone | 704-377-0375
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Fax | 704-342-4737
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Provider Business Mailing Address
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Address Line | 1928 RANDOLPH RD STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28207-1105
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Country | US
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Telephone | 704-377-0375
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Fax | 704-342-4737
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Authorized Official
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Title or Position | OWNER AUDIOLOGIST
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Name | MRS. KATHY ROSE DOWD
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Credential | CCC-A
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Telephone | 704-377-0375
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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 | 1661
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License Number State | NC
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