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NPI Code Detail

MEDICARE: DR. SHANE CHASE AUDIOLOGIST

MEDICARE: DR. SHANE CHASE AUDIOLOGIST
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
1231H00000XAudiologistA-228NV
2231HA2400XAssistive Technology Practitioner AudiologistA-228NV
3235500000XSpeech/Language/Hearing Specialist/TechnologistA-228NV
42355A2700XAudiology AssistantA-228NV

General Provider Information

NPI Number : 1689988180
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANE CHASE AUDIOLOGIST
Provider Business Mailing Address
First Line : 3120 S RAINBOW BLVD STE 202
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6235
Country : US
Telephone Number : 702-233-4327
Fax Number : 702-233-8837
Provider Business Practice Location Address
First Line : 3120 S RAINBOW BLVD STE 202
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6235
Country : US
Telephone Number : 702-233-4327
Fax Number : 702-233-8837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2010
Last Update Date : 07/27/2010

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Directions to “ DR. SHANE CHASE AUDIOLOGIST” Practice Location

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