Provider Demographics
NPI:1780013367
Name:KNOX AUDIOLOGY LLC
Entity Type:Organization
Organization Name:KNOX AUDIOLOGY LLC
Other - Org Name:KNOX AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:757-774-8801
Mailing Address - Street 1:108 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4434
Mailing Address - Country:US
Mailing Address - Phone:757-774-8801
Mailing Address - Fax:757-539-0989
Practice Address - Street 1:108 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4434
Practice Address - Country:US
Practice Address - Phone:757-774-8801
Practice Address - Fax:757-539-0989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001407231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty