Provider Demographics
NPI:1891403259
Name:WHITNEY SWANDER AUDIOLOGY INC
Entity Type:Organization
Organization Name:WHITNEY SWANDER AUDIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:GABY
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-776-8748
Mailing Address - Street 1:1315 VIVIAN ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3216
Mailing Address - Country:US
Mailing Address - Phone:303-776-8748
Mailing Address - Fax:303-684-9915
Practice Address - Street 1:320 E 1ST AVE STE 102
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-3786
Practice Address - Country:US
Practice Address - Phone:303-776-8748
Practice Address - Fax:303-404-9293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty