Provider Demographics
NPI:1174520811
Name:HERHOLTZ, WILLIAM F III (AUD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:HERHOLTZ
Suffix:III
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1396 S 21ST ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-4261
Mailing Address - Country:US
Mailing Address - Phone:719-520-3311
Mailing Address - Fax:719-471-2823
Practice Address - Street 1:1396 S 21ST ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-4261
Practice Address - Country:US
Practice Address - Phone:719-520-3311
Practice Address - Fax:719-471-2823
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO249231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC479978Medicare PIN