| NPI | 1659523694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZA S. PETERSEN Manager/Member/Audiologist 208-569-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WY A-974) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: ID AUD1142) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: WY A-974) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: ID AUD1142) | |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2008-10-22 |