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General NPI Number Information
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NPI Number | 1710193677
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Entity Type | Organization
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Legal Business Name | IRIZ PEREZ
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 96 HAYES ST STE 102
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City | CROSSVILLE
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State | TN
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Zip | 38555-8007
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Country | US
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Telephone | 877-307-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 96 HAYES ST STE 102
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City | CROSSVILLE
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State | TN
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Zip | 38555-8007
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Country | US
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Telephone | 877-307-6654
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IRIZ PEREZ
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Credential |
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Telephone | 877-307-6654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | TN
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