Organization
FOREST LAKE AUDIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD GIBSON AUDIOLOGIST (OWNER)
(803) 888-7330
Entity
Organization
Contact information
Practice address
5301 N TRENHOLM RD, SUITE A, COLUMBIA, SC 29206-3226
(803) 888-7330
Mailing address
5301 N TRENHOLM RD, SUITE A, COLUMBIA, SC 29206-3226
(803) 888-7330
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
SC3435
SC
Other
Enumeration date
01/05/2016
Last updated
03/16/2016
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