Provider Demographics
NPI:1790983104
Name:CENTER FOR AUDIOLOGY, PC
Entity Type:Organization
Organization Name:CENTER FOR AUDIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMIKO
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:LEJEUNE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:931-645-3937
Mailing Address - Street 1:1740 MEMORIAL DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4561
Mailing Address - Country:US
Mailing Address - Phone:931-645-3937
Mailing Address - Fax:
Practice Address - Street 1:1740 MEMORIAL DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4561
Practice Address - Country:US
Practice Address - Phone:931-645-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech