Provider Demographics
NPI:1396080966
Name:LTC AUDIOLOGY SERVICES, LLC
Entity type:Organization
Organization Name:LTC AUDIOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:PAYNE
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:517-974-7797
Mailing Address - Street 1:6204 BRIDGEWATER CIR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-9216
Mailing Address - Country:US
Mailing Address - Phone:517-974-7797
Mailing Address - Fax:517-253-8429
Practice Address - Street 1:6204 BRIDGEWATER CIR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-974-7797
Practice Address - Fax:517-253-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment