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General NPI Number Information
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NPI Number | 1003212085
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Entity Type | Organization
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Legal Business Name | DIATECH ONCOLOGY, LLC
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Dates
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Enumeration Date | 11/18/2014
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 405 DUKE DR SUITE 240
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City | FRANKLIN
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State | TN
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Zip | 37067-2706
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Country | US
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Telephone | 615-567-0200
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Fax | 615-567-0201
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Provider Business Mailing Address
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Address Line | 405 DUKE DR SUITE 240
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City | FRANKLIN
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State | TN
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Zip | 37067-2706
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Country | US
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Telephone | 615-567-0200
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Fax | 615-567-0201
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. ROBERT E HENRY
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Credential |
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Telephone | 615-567-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 44D2072093 CLIA
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License Number State |
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