Community Pathology Laboratory LLC
Specialist in Cookeville, TN. Organization (NPI-2).
NPI number1366440570
StatusActive
Last updated in NPPESJan 16, 2008
Details
- NPI
- 1366440570
- Entity type
- Organization (NPI-2)
- Legal business name
- Community Pathology Laboratory LLC
- Organization subpart
- No
- Enumeration date
- Jul 12, 2005
- Last updated
- Jan 16, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 1965 | TN | Yes |
Other names
- Cookeville Pathology Lab (Doing Business As)
Practice location
115 N Peachtree AveCookeville, TN 38501-2546
Phone 931-528-2836 · Fax 931-520-8650
Mailing address
115 N Peachtree AveCookeville, TN 38501-2546
Phone 931-528-2836 · Fax 931-520-8650
Authorized official
Michael Thomas Hall
Office Mgr
9315282836
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