Provider Demographics
NPI:1942683776
Name:AHLBERG AUDIOLOGY AND HEARING AID SERVICES LLC
Entity Type:Organization
Organization Name:AHLBERG AUDIOLOGY AND HEARING AID SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:AHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:423-641-0959
Mailing Address - Street 1:4220 OCOEE ST N
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-4829
Mailing Address - Country:US
Mailing Address - Phone:423-641-0956
Mailing Address - Fax:
Practice Address - Street 1:4220 OCOEE ST N
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-4829
Practice Address - Country:US
Practice Address - Phone:423-641-0956
Practice Address - Fax:423-641-0956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1246231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty