Organization
TRACUT LLC
Active
Parent organization
CENTER FOR UROLOGICAL TREATMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTER FOR UROLOGICAL TREATMENT
Authorized official
DR. MITCHELL WIATRAK M.D. (CHEIF MANAGER)
(615) 327-2055
Entity
Organization
Contact information
Practice address
127 CRESTVIEW PARK DR, 207, DICKSON, TN 37055-2855
(615) 327-2055
Mailing address
345 23RD AVE N, 212, NASHVILLE, TN 37203-1513
(615) 327-2055
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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