Provider Demographics
NPI:1154632123
Name:ALAN YOUNG AUDIOLOGY, PLLC
Entity type:Organization
Organization Name:ALAN YOUNG AUDIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARRON
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:KIMBALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-713-0101
Mailing Address - Street 1:5642 SOUTH 900 EAST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1066
Mailing Address - Country:US
Mailing Address - Phone:801-713-0101
Mailing Address - Fax:801-262-1091
Practice Address - Street 1:5642 SOUTH 900 EAST
Practice Address - Street 2:SUITE #1
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-1066
Practice Address - Country:US
Practice Address - Phone:801-713-0101
Practice Address - Fax:801-262-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT348193-4101237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty