Organization
LBL ESD AUDIOLOGY
Active
Organization
LBL ESD AUDIOLOGY
Active
Other names
LBL ESD
Organization subpart
No
Provider details
NPI number
Authorized official
JON E TAYLOR (BUSINESS SERVICES DIRECTOR)
(541) 812-2600
Entity
Organization
Contact information
Practice address
905 4TH AVE SE, ALBANY, OR 97321-3104
(541) 812-2600
(541) 926-6047
Mailing address
905 4TH AVE SE, ALBANY, OR 97321-3104
(541) 812-2600
(541) 926-6047
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
062028
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NEW APPLICATION
—
OR
Enumeration date
05/09/2007
Last updated
08/22/2020
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