Provider Demographics
NPI:1427223536
Name:STUCKI, LUND LEO (AUDIOPROSTHOLOGIST B)
Entity Type:Individual
Prefix:MR
First Name:LUND
Middle Name:LEO
Last Name:STUCKI
Suffix:
Gender:M
Credentials:AUDIOPROSTHOLOGIST B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1847 PACIFIC AVE
Mailing Address - Street 2:AFFORDABLE HEARING CARE
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401
Mailing Address - Country:US
Mailing Address - Phone:928-753-7060
Mailing Address - Fax:928-753-7078
Practice Address - Street 1:1847 PACIFIC AVE
Practice Address - Street 2:AFFORDABLE HEARING CARE
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401
Practice Address - Country:US
Practice Address - Phone:928-753-7060
Practice Address - Fax:928-753-7078
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBHAD4989237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0421540OtherBCBS