Provider Demographics
NPI:1649402058
Name:FYNES AUDIOLOGY LLC
Entity Type:Organization
Organization Name:FYNES AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:MARION
Authorized Official - Last Name:FYNES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD CCC-A
Authorized Official - Phone:480-456-0176
Mailing Address - Street 1:2058 S DOBSON RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6454
Mailing Address - Country:US
Mailing Address - Phone:480-456-0176
Mailing Address - Fax:480-302-4165
Practice Address - Street 1:2058 S DOBSON RD
Practice Address - Street 2:SUITE 10
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6454
Practice Address - Country:US
Practice Address - Phone:480-456-0176
Practice Address - Fax:480-302-4165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1798237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty