Provider Demographics
NPI:1477699676
Name:GOSS, DIANNA MARIE (RT (R))
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:MARIE
Last Name:GOSS
Suffix:
Gender:F
Credentials:RT (R)
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Other - Credentials:
Mailing Address - Street 1:90 AUTUMN TRCE
Mailing Address - Street 2:
Mailing Address - City:ODENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35120-6758
Mailing Address - Country:US
Mailing Address - Phone:205-467-9468
Mailing Address - Fax:
Practice Address - Street 1:3502 RAINBOW DR # B
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-6310
Practice Address - Country:US
Practice Address - Phone:256-442-2779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging