Provider Demographics
NPI:1619638129
Name:MAZZONE, DEVIN THOMAS (RT (R)(CT)(ARRT))
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:THOMAS
Last Name:MAZZONE
Suffix:
Gender:M
Credentials:RT (R)(CT)(ARRT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 SMITH PL
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4565
Mailing Address - Country:US
Mailing Address - Phone:307-365-1122
Mailing Address - Fax:
Practice Address - Street 1:3014 SMITH PL
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4565
Practice Address - Country:US
Practice Address - Phone:307-365-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY10080422471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography