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General NPI Number Information
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NPI Number | 1831151927
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Entity Type | Organization
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Legal Business Name | MIAMI VALLEY CYTOLOGY
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 7415 BRANDT PIKE
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-3239
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Country | US
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Telephone | 937-293-0773
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Fax |
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Provider Business Mailing Address
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Address Line | 999 BRUBAKER DR
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City | KETTERING
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State | OH
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Zip | 45429-3588
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Country | US
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Telephone | 937-293-0773
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Fax |
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Authorized Official
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Title or Position | CYTOLOGIST
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Name | MR. WILLARD YAREMA
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Credential | M.S.
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Telephone | 937-293-0773
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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 | 36DO350260
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License Number State | OH
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