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NPI Code Detail

MEDICARE: LUIS ALTAMIRANO

MEDICARE: LUIS ALTAMIRANO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1528710357
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS ALTAMIRANO
Provider Business Mailing Address
First Line : 2740 SAINT ANDREWS DR STE 100
Second Line :
City : MURFREESBORO
State : TN
Zip : 37128-6684
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2740 SAINT ANDREWS DR STE 100
Second Line :
City : MURFREESBORO
State : TN
Zip : 37128-6684
Country : US
Telephone Number : 615-564-4984
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2022
Last Update Date : 01/23/2022

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Directions to “ LUIS ALTAMIRANO ” Practice Location

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