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Organization
EAR NOSE THROAT AND AUDIOLOGY ASSOCIATES
Active
Organization
EAR NOSE THROAT AND AUDIOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY BROADNAX (OFFICE MANAGER)
(704) 544-6533
Entity
Organization
Contact information
Practice address
327 W SOUTH ST, UNION, SC 29379-2838
(864) 429-0115
(864) 429-0271
Mailing address
8318 PINEVILLE MATTHEWS RD, SUITE 708-151, CHARLOTTE, NC 28226-4753
(704) 544-6533
(704) 544-6583
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
NULL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
—
Other
Enumeration date
01/09/2009
Last updated
01/09/2009
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