Provider Demographics
NPI:1225596034
Name:JAYBIRD AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:JAYBIRD AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BESS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:801-440-9899
Mailing Address - Street 1:10073 S COPPER KING LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-2477
Mailing Address - Country:US
Mailing Address - Phone:801-440-9899
Mailing Address - Fax:
Practice Address - Street 1:3556 W 9800 S STE 102
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-3225
Practice Address - Country:US
Practice Address - Phone:801-440-9899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech