Provider Demographics
NPI:1922395268
Name:HENZLER, GREGORY (CNIM)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:HENZLER
Suffix:
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W END AVE
Mailing Address - Street 2:SUITE 1610
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2526
Mailing Address - Country:US
Mailing Address - Phone:615-928-6075
Mailing Address - Fax:615-457-1447
Practice Address - Street 1:1801 W END AVE
Practice Address - Street 2:SUITE 1610
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2526
Practice Address - Country:US
Practice Address - Phone:615-928-6075
Practice Address - Fax:615-457-1447
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist