Individual
LARRY STEVEN FREEMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARRT (R), CNMT
Contact information
Practice address
JAMES H. QUILLEN VA MEDICAL CENTER, MOUNTAIN HOME, TN 37684
(423) 926-1171
(423) 979-3414
Mailing address
2702 WINDWOOD DR, JOHNSON CITY, TN 37604-5958
(423) 926-6978
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
337987
MN
247100000X
Radiologic Technologist
Primary
526609
TN
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
037775
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037775
NUCLEAR MEDICINE TECHNOLOGY CERTIFICATION BOARD (NMTCB), NATIONAL CERTIFICATION
GA
01
—
337987
THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGIST (ARRT), NATIONAL CERTIFICATION
MN
01
—
MDX0000008167
CERTIFIED MEDICAL X-RAY TECHNOLOGIST
TN
Enumeration date
11/20/2013
Last updated
11/20/2013
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