Basic Information
| Provider Information | |||||||||
| NPI: | 1982839452 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOCAL HEARING AID AND AUDIOLOGY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 827 19TH ST N | ||||||||
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| City: | BESSEMER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350203456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2054261801 | ||||||||
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| Practice Location | |||||||||
| Address1: | 827 19TH ST N | ||||||||
| Address2: | |||||||||
| City: | BESSEMER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350203456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2054261801 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2009 | ||||||||
| LastUpdateDate: | 05/27/2009 | ||||||||
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| AuthorizedOfficialLastName: | DOUGLAS | ||||||||
| AuthorizedOfficialFirstName: | LESLIE | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2054261801 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 572A | AL | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.