Provider Demographics
NPI:1215118237
Name:AUDIOLOGY ASSOCIATES INC
Entity type:Organization
Organization Name:AUDIOLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HURT
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:573-651-4650
Mailing Address - Street 1:2917 INDEPENDENCE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5044
Mailing Address - Country:US
Mailing Address - Phone:573-651-4650
Mailing Address - Fax:573-651-5212
Practice Address - Street 1:2917 INDEPENDENCE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5044
Practice Address - Country:US
Practice Address - Phone:573-651-4650
Practice Address - Fax:573-651-5212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00545225100000X
MO01354231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty