Healthcare Provider Details
I. General information
NPI: 1477932481
Provider Name (Legal Business Name): GIARRIZZI TRANSITIONS MHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
317 RUTH VISTA RD
LEXINGTON SC
29073-8628
US
IV. Provider business mailing address
317 RUTH VISTA RD
LEXINGTON SC
29073-8628
US
V. Phone/Fax
- Phone: 972-616-4932
- Fax: 877-489-3949
- Phone: 972-616-4932
- Fax: 877-489-3949
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | SC |
VIII. Authorized Official
Name:
DANA
GIARRIZZI
Title or Position: OWNER / PRESIDENT
Credential: DO
Phone: 814-312-1988