Provider Demographics
NPI:1124365754
Name:EMBERLIN, LUKE JOHN (AUD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:JOHN
Last Name:EMBERLIN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 E. MAIN ST. UNIT A
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714
Mailing Address - Country:US
Mailing Address - Phone:406-296-4327
Mailing Address - Fax:406-296-4328
Practice Address - Street 1:23 E. MAIN ST. UNIT A
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714
Practice Address - Country:US
Practice Address - Phone:406-296-4327
Practice Address - Fax:406-296-4328
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2544231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist