Lauren R Stack AUD

NPI 1760493290 - Audiologist - 231H00000X

NPI Details
NPI 1760493290
Gender Female
Enumeration Date 08/10/2006
Last Updated 09/06/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
807 CHILDRENS WAY
JACKSONVILLE FL, 32207-8426, US
Phone (904) 390-3690
Fax (904) 390-3502
Business Location
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND DE, 19732-0191, US
Phone (302) 651-6212
Fax (302) 651-4945
Toxanomy
Taxonomy Code 231H00000X
License State Florida
License Number AZ504
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According to our database, Ms. Lauren R Stack AUD NPI is 1760493290, taxonomy code is 231H00000X and license number is AZ504, license state is located at Florida. Lauren R Stack AUD physically located at 807 Childrens Way, Jacksonville FL, 32207-8426. NPI Number Lauren R Stack AUD has the Individual type.

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1760493290 NPI number is provided on an as is basis without warranty of any kind. 1760493290 is maintained by the National Plan & Provider Enumeration System. The contents of Lauren R Stack AUD are for informational purposes only.