Provider Demographics
NPI:1235301441
Name:AUDIOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:AUDIOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:C
Authorized Official - Last Name:OTTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-363-2336
Mailing Address - Street 1:1750 S RAINBOW BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-2949
Mailing Address - Country:US
Mailing Address - Phone:702-363-2336
Mailing Address - Fax:702-877-3874
Practice Address - Street 1:1750 S RAINBOW BLVD STE 2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-2949
Practice Address - Country:US
Practice Address - Phone:702-363-2336
Practice Address - Fax:702-877-3874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA138231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty