Provider Demographics
NPI:1184898991
Name:POLAND, RON
Entity type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:POLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 CROMWELL DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-6307
Mailing Address - Country:US
Mailing Address - Phone:615-972-3334
Mailing Address - Fax:615-340-0028
Practice Address - Street 1:114 POWELL DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3527
Practice Address - Country:US
Practice Address - Phone:615-340-0068
Practice Address - Fax:615-340-0028
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier