Provider Demographics
NPI:1750949749
Name:AUDIOLOGY ADVANTAGE LLC
Entity type:Organization
Organization Name:AUDIOLOGY ADVANTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:541-887-0123
Mailing Address - Street 1:4036 S 6TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4750
Mailing Address - Country:US
Mailing Address - Phone:541-887-0123
Mailing Address - Fax:
Practice Address - Street 1:4036 S 6TH ST STE 3
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4750
Practice Address - Country:US
Practice Address - Phone:541-887-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty