Provider Demographics
NPI:1801102645
Name:NOSOMA AUDIOLOGY, LLC
Entity type:Organization
Organization Name:NOSOMA AUDIOLOGY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:970-593-1509
Mailing Address - Street 1:2902 GINNALA DR STE 3
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7818
Mailing Address - Country:US
Mailing Address - Phone:970-593-1509
Mailing Address - Fax:970-593-6810
Practice Address - Street 1:2902 GINNALA DR STE 3
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-7818
Practice Address - Country:US
Practice Address - Phone:970-593-1509
Practice Address - Fax:970-593-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO461231HA2400X, 231HA2500X, 237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty