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General NPI Number Information
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NPI Number | 1730313404
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA RADIATION ONCOLOGY CENTER, PLLC
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 605 GLENWOOD DR SUITE 212
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1108
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Country | US
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Telephone | 423-697-9890
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Fax | 423-697-9891
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Provider Business Mailing Address
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Address Line | 605 GLENWOOD DR SUITE 212
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1108
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Country | US
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Telephone | 423-697-9890
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Fax | 423-697-9891
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | DIANNE L TUCKER
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Credential |
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Telephone | 423-697-9890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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