Organization
AUDIOLOGY SPECIALTY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDSEY KOCH AUD (OWNER)
(605) 275-5545
Entity
Organization
Contact information
Practice address
5124 S WESTERN AVE, SUITE 4, SIOUX FALLS, SD 57108-5047
(605) 275-5545
(605) 275-5546
Mailing address
5124 S WESTERN AVE, SUITE 4, SIOUX FALLS, SD 57108-5047
(605) 275-5545
(605) 275-5546
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
11
SD
231H00000X
Audiologist
16
SD
231H00000X
Audiologist
Primary
375
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11
AUDIOLOGY LICENSE
SD
01
—
1184899882
NPI
SD
01
—
1487964144
NPI
SD
01
—
1538334131
NPI
SD
01
—
16
AUDIOLOGY LICENSE
SD
01
—
375
AUDIOLOGY LICENSE
SD
Enumeration date
06/04/2012
Last updated
06/04/2012
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