Organization Name: | ORTHOTENNESSEE, PC |
NPI Number: | 1083796064 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GLENN SUMNER (CEO) |
Mailing Address: | 90 Vermont Ave Suite 300 Oak Ridge |
State: | TN US |
Postal Code: | 378306474 |
Phone Number: | 8654829025 |
Fax Number: | 8654838151 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 03/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
Taxonomy Definition: |