Provider Demographics
NPI:1598293177
Name:GAMEWELL AUDIOLOGY, PLLC
Entity Type:Organization
Organization Name:GAMEWELL AUDIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:GAMEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:828-287-1038
Mailing Address - Street 1:PO BOX 1251
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-1251
Mailing Address - Country:US
Mailing Address - Phone:828-287-1038
Mailing Address - Fax:828-287-1037
Practice Address - Street 1:420 CHARLOTTE RD
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2918
Practice Address - Country:US
Practice Address - Phone:828-287-1038
Practice Address - Fax:828-287-1037
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GAMEWELL AUDIOLOGY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3755231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty