Provider Demographics
NPI:1730422338
Name:PLATINUM SOUND LLC
Entity type:Organization
Organization Name:PLATINUM SOUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:KELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-392-5350
Mailing Address - Street 1:1088 W RIVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84405-3721
Mailing Address - Country:US
Mailing Address - Phone:801-392-5350
Mailing Address - Fax:801-392-5370
Practice Address - Street 1:1088 W RIVERDALE RD
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:UT
Practice Address - Zip Code:84405-3721
Practice Address - Country:US
Practice Address - Phone:801-392-5350
Practice Address - Fax:801-392-5370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty