Provider Demographics
NPI:1386466639
Name:MOBILE AUDIOLOGY LLC
Entity type:Organization
Organization Name:MOBILE AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ENOCH
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:801-486-9309
Mailing Address - Street 1:6947 W 9770 N
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-9355
Mailing Address - Country:US
Mailing Address - Phone:801-706-9807
Mailing Address - Fax:
Practice Address - Street 1:3450 N TRIUMPH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6132
Practice Address - Country:US
Practice Address - Phone:801-706-9807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty