Provider Demographics
NPI:1003255456
Name:WOODWARD AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:WOODWARD AUDIOLOGY, LLC
Other - Org Name:HEARING CARE PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LUCKETT
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-A
Authorized Official - Phone:660-665-9114
Mailing Address - Street 1:101 S BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-3749
Mailing Address - Country:US
Mailing Address - Phone:660-665-9114
Mailing Address - Fax:573-756-0505
Practice Address - Street 1:101 S BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3749
Practice Address - Country:US
Practice Address - Phone:660-665-9114
Practice Address - Fax:573-756-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001006100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty