Organization
EQUISTAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAMAR L YOUNG PH.D. (CLINICAL DIRECTOR)
(704) 482-1447
Entity
Organization
Contact information
Practice address
1403 N LAFAYETTE ST, SHELBY, NC 28150-3406
(704) 482-1447
(704) 481-9744
Mailing address
1403 N LAFAYETTE ST, SHELBY, NC 28150-3406
(704) 482-1447
(704) 481-9744
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89014G5
—
NC
Enumeration date
04/03/2006
Last updated
03/22/2010
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