Provider Demographics
NPI:1215691928
Name:AUDIOLOGY CENTER OF NORTHERN COLORADO LLC
Entity type:Organization
Organization Name:AUDIOLOGY CENTER OF NORTHERN COLORADO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:G. NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:970-988-6037
Mailing Address - Street 1:2001 S SHIELDS ST STE H102
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1727
Mailing Address - Country:US
Mailing Address - Phone:970-893-7621
Mailing Address - Fax:970-893-7622
Practice Address - Street 1:2001 S SHIELDS ST STE H102
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1727
Practice Address - Country:US
Practice Address - Phone:970-893-7621
Practice Address - Fax:970-893-7622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty