Organization
PROFESSIONAL AUDIOLOGICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA COLTHARP MORTON AU.D. (PRESIDENT)
(901) 372-0040
Entity
Organization
Contact information
Practice address
5118 STAGE RD, MEMPHIS, TN 38134-3166
(901) 372-0040
(901) 372-8685
Mailing address
5108 STAGE RD, MEMPHIS, TN 38134-3164
(901) 372-0040
(901) 372-8685
Taxonomy
Speciality
Code
Description
License number
State
231HA2500X
Assistive Technology Supplier Audiologist
Primary
A103
TN
332B00000X
Durable Medical Equipment & Medical Supplies
A103
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529238
—
TN
Enumeration date
10/12/2012
Last updated
10/12/2012
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