Provider Demographics
NPI:1710879051
Name:LAROSE AUDIOLOGY LLC
Entity type:Organization
Organization Name:LAROSE AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:LAROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:505-297-9574
Mailing Address - Street 1:58 CARSON VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-1443
Mailing Address - Country:US
Mailing Address - Phone:505-297-9574
Mailing Address - Fax:
Practice Address - Street 1:2945 RODEO PARK DR E UNIT 1A
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6312
Practice Address - Country:US
Practice Address - Phone:505-297-9574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty