Provider Demographics
NPI:1619055712
Name:TRUSTEES OF PURDUE UNIVERSITY
Entity Type:Organization
Organization Name:TRUSTEES OF PURDUE UNIVERSITY
Other - Org Name:M.D. STEER AUDIOLOGY & SPEECH-LANGUAGE CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:TRENTEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KLINGERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-496-6846
Mailing Address - Street 1:601 STADIUM MALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47907-2052
Mailing Address - Country:US
Mailing Address - Phone:765-496-1927
Mailing Address - Fax:765-496-1227
Practice Address - Street 1:715 CLINIC DR
Practice Address - Street 2:ROOM 1042
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2122
Practice Address - Country:US
Practice Address - Phone:765-494-3789
Practice Address - Fax:765-494-0771
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PURDUE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-02
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech