Provider Demographics
NPI:1558977462
Name:SOUND ADVICE AUDIOLOGY NORTH LLC
Entity Type:Organization
Organization Name:SOUND ADVICE AUDIOLOGY NORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WIGHTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:248-477-6682
Mailing Address - Street 1:31148 GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-4277
Mailing Address - Country:US
Mailing Address - Phone:248-477-6682
Mailing Address - Fax:248-477-4746
Practice Address - Street 1:31148 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-4277
Practice Address - Country:US
Practice Address - Phone:248-477-6682
Practice Address - Fax:248-477-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1316248883OtherNPI