Provider Demographics
NPI:1760575831
Name:FORCZEK, RONALD SCOTT (CRTT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:SCOTT
Last Name:FORCZEK
Suffix:
Gender:M
Credentials:CRTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 WEST END AVE #126-266
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-353-7979
Mailing Address - Fax:
Practice Address - Street 1:8265 TROUSDALE FERRY PIKE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090
Practice Address - Country:US
Practice Address - Phone:615-353-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42192278P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Diagnostics