Provider Demographics
NPI:1033972849
Name:MIDWEST AUDIOLOGY SPECIALISTS LLC
Entity Type:Organization
Organization Name:MIDWEST AUDIOLOGY SPECIALISTS LLC
Other - Org Name:MIDWEST AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN VOORST
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:319-249-6925
Mailing Address - Street 1:585 W CHERRY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-0187
Mailing Address - Country:US
Mailing Address - Phone:319-365-0005
Mailing Address - Fax:
Practice Address - Street 1:585 W CHERRY ST STE A
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9797
Practice Address - Country:US
Practice Address - Phone:319-249-6925
Practice Address - Fax:319-205-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty