Organization
MEDICAL TECHNOLOGIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONAY W TUCKER (PRACTICE MANAGER)
(229) 386-4987
Entity
Organization
Contact information
Practice address
1105 20TH ST E, TIFTON, GA 31794-3668
(229) 386-4987
Mailing address
1105 20TH ST E, TIFTON, GA 31794-3668
(229) 386-4987
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/28/2007
Last updated
11/28/2007
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