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NPI Code Detail

MEDICARE: AUDIOLOGY ADVANTAGE LLC

MEDICARE: AUDIOLOGY ADVANTAGE LLC
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
1231H00000XAudiologist

General Provider Information

NPI Number : 1750949749
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUDIOLOGY ADVANTAGE LLC
Provider Business Mailing Address
First Line : 4036 S 6TH ST STE 3
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97603-4750
Country : US
Telephone Number : 541-887-0123
Fax Number :
Provider Business Practice Location Address
First Line : 4036 S 6TH ST STE 3
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97603-4750
Country : US
Telephone Number : 541-887-0123
Fax Number :
Authorized Official
Title or Position : OWNER, AUDIOLOGIST
Name : DR. AMBER WU
Credential : AUD
Telephone Number : 541-887-0123
Provider Enumeration Date : 06/04/2019
Last Update Date : 06/04/2019

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Directions to “AUDIOLOGY ADVANTAGE LLC ” Practice Location

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