Organization
MURFREESBORO AUDIOLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH G STOCKDELL SR. (AUDIOLOGIST)
(615) 890-3686
Entity
Organization
Contact information
Practice address
811 S CHURCH ST, MURFREESBORO, TN 37130-4927
(615) 890-3686
(615) 890-0688
Mailing address
811 S CHURCH ST, MURFREESBORO, TN 37130-4927
(615) 890-3686
(615) 890-0688
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
75
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4043611
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
Enumeration date
07/25/2012
Last updated
07/25/2012
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