Provider Demographics
NPI:1174778930
Name:WAITS SCIENTIFIC CORPORATION
Entity type:Organization
Organization Name:WAITS SCIENTIFIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDIENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WAITS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:770-461-0043
Mailing Address - Street 1:174A BANKS XING
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7308
Mailing Address - Country:US
Mailing Address - Phone:770-461-0043
Mailing Address - Fax:770-460-7897
Practice Address - Street 1:174A BANKS XING
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7308
Practice Address - Country:US
Practice Address - Phone:770-461-0043
Practice Address - Fax:770-460-7897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD001514231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty