MEDICARE: ADVANCED AUDIOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	2237	KS

General Provider Information

NPI Number	:	1164861779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED AUDIOLOGY INC

Provider Business Mailing Address
First Line	:	1133 COLLEGE AVE
Second Line	:	SUITE C145
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2751
Country	:	US
Telephone Number	:	785-320-7388
Fax Number	:	785-320-6056

Provider Business Practice Location Address
First Line	:	1133 COLLEGE AVE
Second Line	:	SUITE C145
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2751
Country	:	US
Telephone Number	:	785-320-7388
Fax Number	:	785-320-6056

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DR. KATHRYN J BUNKER
Credential	:	AUD
Telephone Number	:	785-320-7388

Provider Enumeration Date	:	06/17/2013
Last Update Date	:	07/02/2015

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