Provider Demographics
NPI:1992095087
Name:PTC LABORATORIES, INC.
Entity type:Organization
Organization Name:PTC LABORATORIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKWITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-442-9948
Mailing Address - Street 1:300 PORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6569
Mailing Address - Country:US
Mailing Address - Phone:573-442-9948
Mailing Address - Fax:573-442-9870
Practice Address - Street 1:300 PORTLAND ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6569
Practice Address - Country:US
Practice Address - Phone:573-442-9948
Practice Address - Fax:573-442-9870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory