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General NPI Number Information
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NPI Number | 1831908292
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Entity Type | Organization
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Legal Business Name | NORTHLAND AUDIOLOGY LLC
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 370 3RD AVE
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City | CLEAR LAKE
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State | WI
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Zip | 54005
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Country | US
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Telephone | 715-641-2526
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Fax |
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Provider Business Mailing Address
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Address Line | 179 3RD AVE
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City | CLAYTON
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State | WI
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Zip | 54004-8927
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL SCHULTZ
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Credential |
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Telephone | 715-977-2236
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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 |
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License Number State |
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