MEDICARE: AMBER ANN LLOYD BC-HIS, ACA

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	237700000X	Hearing Instrument Specialist	4988314-4601	UT

General Provider Information

NPI Number	:	1255724910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER ANN LLOYD BC-HIS, ACA

Provider Business Mailing Address
First Line	:	1817 S MAIN ST STE 7
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-7054
Country	:	US
Telephone Number	:	801-485-5595
Fax Number	:	801-467-1125

Provider Business Practice Location Address
First Line	:	1817 S MAIN ST STE 7
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-7054
Country	:	US
Telephone Number	:	801-485-5595
Fax Number	:	801-467-1125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	03/05/2015

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