Provider Demographics
NPI:1417512682
Name:ADVANCED AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:ADVANCED AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:LAVERNE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-669-8080
Mailing Address - Street 1:1536 HASLETT RD
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8472
Mailing Address - Country:US
Mailing Address - Phone:517-896-4452
Mailing Address - Fax:517-669-8070
Practice Address - Street 1:1536 HASLETT RD
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8472
Practice Address - Country:US
Practice Address - Phone:517-896-4452
Practice Address - Fax:517-669-8070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED AUDIOLOGY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty