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General NPI Number Information
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NPI Number | 1790244168
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Entity Type | Organization
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Legal Business Name | IRON HORSE DIAGNOSTICS, INC.
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 124 W THOMAS RD STE 200
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City | PHOENIX
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State | AZ
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Zip | 85013-4416
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Country | US
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Telephone | 602-617-7609
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Fax |
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Provider Business Mailing Address
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Address Line | 21053 N 75TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-4771
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Country | US
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Telephone | 602-617-7609
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MICHAEL HULL
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Credential |
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Telephone | 602-617-7609
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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 |
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