Provider Demographics
NPI:1619415338
Name:MEMPHIS AUDIOLOGY LLC
Entity Type:Organization
Organization Name:MEMPHIS AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:901-221-7792
Mailing Address - Street 1:793 W POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2543
Mailing Address - Country:US
Mailing Address - Phone:901-310-5983
Mailing Address - Fax:901-221-7794
Practice Address - Street 1:793 W POPLAR AVE
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2543
Practice Address - Country:US
Practice Address - Phone:901-310-5983
Practice Address - Fax:901-221-7794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty