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General NPI Number Information
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NPI Number | 1306761705
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Entity Type | Organization
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Legal Business Name | EMBRYOME DBA JUNIPER GENOMICS
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 6901 QUAKER AVE STE A
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City | LUBBOCK
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State | TX
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Zip | 79413-5944
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Country | US
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Telephone | 202-599-4605
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Fax |
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Provider Business Mailing Address
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Address Line | 4860 WASHTENAW AVE STE I #319
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City | ANN ARBOR
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State | MI
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Zip | 48108-3401
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Country | US
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Telephone | 202-599-4605
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JEREMY GRUSHCOW
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Credential | PHD, JD
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Telephone | 202-599-4605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QG0250X
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Taxonomy Name | Genetics Clinic/Center
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License Number |
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License Number State |
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