Provider Demographics
NPI:1023272887
Name:ROSE, BRUTUS ROLAND (RT)
Entity type:Individual
Prefix:
First Name:BRUTUS
Middle Name:ROLAND
Last Name:ROSE
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-2934
Mailing Address - Country:US
Mailing Address - Phone:423-622-7212
Mailing Address - Fax:
Practice Address - Street 1:1301 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2934
Practice Address - Country:US
Practice Address - Phone:423-622-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging