Organization
COMMONWEALTH AUDIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M BANE MD (OWNER)
(703) 878-0777
Entity
Organization
Contact information
Practice address
2280 OPITZ BLVD, SUITE 340, WOODBRIDGE, VA 22191-3362
(703) 878-0777
(703) 583-1777
Mailing address
2280 OPITZ BLVD, SUITE 340, WOODBRIDGE, VA 22191-3362
(703) 878-0777
(703) 583-1777
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
—
—
Other
Enumeration date
08/17/2011
Last updated
10/04/2011
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