Provider Demographics
NPI:1003009325
Name:AUDIOLOGY CONSULTANTS OF SOUTHERN OREGON, INC.
Entity Type:Organization
Organization Name:AUDIOLOGY CONSULTANTS OF SOUTHERN OREGON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-672-8868
Mailing Address - Street 1:1367 W HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-2838
Mailing Address - Country:US
Mailing Address - Phone:541-672-8868
Mailing Address - Fax:541-672-1142
Practice Address - Street 1:1367 W HARVARD AVE
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-2838
Practice Address - Country:US
Practice Address - Phone:541-672-8868
Practice Address - Fax:541-672-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22652231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty