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General NPI Number Information
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NPI Number | 1902234545
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Entity Type | Organization
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Legal Business Name | KREIG D. ROOF, PH.D., PLLC
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 3325 ASPEN GROVE DR SUITE 102
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City | FRANKLIN
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State | TN
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Zip | 37067-2905
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Country | US
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Telephone | 615-778-9978
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Fax | 615-435-3892
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Provider Business Mailing Address
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Address Line | 3325 ASPEN GROVE DR SUITE 102
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City | FRANKLIN
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State | TN
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Zip | 37067-2905
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Country | US
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Telephone | 615-778-9978
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Fax | 615-435-3892
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST
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Name | DR. KREIG DOUGLAS ROOF
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Credential | PH.D
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Telephone | 615-778-9978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | P0000001721
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License Number State | TN
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