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General NPI Number Information
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NPI Number | 1942592928
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Entity Type | Organization
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Legal Business Name | SPIRIT RIVER AUDIOLOGY LLC
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 237 2ND AVE SW #230
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City | CAMBRIDGE
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State | MN
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Zip | 55008-1536
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Country | US
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Telephone | 763-300-3019
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Fax |
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Provider Business Mailing Address
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Address Line | 15201 QUICKSILVER ST
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City | RAMSEY
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State | MN
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Zip | 55303-5694
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Country | US
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Telephone | 763-300-3019
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER
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Name | DR. JOSEPHINE Z. HELMBRECHT
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Credential | AU.D.
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Telephone | 763-300-3019
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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 | 6425
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License Number State | MN
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