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General NPI Number Information
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NPI Number | 1134522410
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Entity Type | Organization
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Legal Business Name | TK DIAGNOSTIC LLC
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 51 RAYMALEY RD
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City | HARRISON CITY
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State | PA
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Zip | 15636
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Country | US
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Telephone | 412-607-2985
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Fax |
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Provider Business Mailing Address
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Address Line | 1024 W 13TH STREET
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City | LAKELAND
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State | FL
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Zip | 33805
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Country | US
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Telephone | 412-607-2985
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KARRIE WOODCOCK
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Credential |
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Telephone | 724-744-0551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246XC2903X
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Taxonomy Name | Vascular Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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