Provider Demographics
NPI:1295828168
Name:ADVANCED AUDIOLOGY CONCEPTS, INC.
Entity Type:Organization
Organization Name:ADVANCED AUDIOLOGY CONCEPTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KUKULA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:440-205-8848
Mailing Address - Street 1:8897 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6211
Mailing Address - Country:US
Mailing Address - Phone:440-205-8848
Mailing Address - Fax:440-205-8848
Practice Address - Street 1:8897 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6211
Practice Address - Country:US
Practice Address - Phone:440-205-8848
Practice Address - Fax:440-205-8848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty