Organization
SHOALS AUDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON P LOCKETTE M.D. (PRESIDENT)
(256) 314-6673
Entity
Organization
Contact information
Practice address
1114 BRADSHAW DR, FLORENCE, AL 35630-1438
(256) 764-2667
Mailing address
1114 BRADSHAW DR, FLORENCE, AL 35630-1438
(256) 764-2667
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
617A
AL
Other
Enumeration date
11/07/2006
Last updated
08/22/2020
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