Provider Demographics
NPI:1427805142
Name:LEGACY AUDIOLOGY, INC.
Entity type:Organization
Organization Name:LEGACY AUDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:TATUM
Authorized Official - Last Name:DANHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:805-683-5322
Mailing Address - Street 1:5360 HOLLISTER AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2334
Mailing Address - Country:US
Mailing Address - Phone:805-696-6811
Mailing Address - Fax:805-696-6453
Practice Address - Street 1:5360 HOLLISTER AVE STE 1
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2334
Practice Address - Country:US
Practice Address - Phone:805-696-6811
Practice Address - Fax:805-696-6453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty