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1588283063
PETER DEREVA
NASHVILLE, TN
NPI
1588283063
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
291U00000X Clinical Medical Laboratory
Enumeration Date
2020-04-14
Last Update Date
2020-04-14
Business Address
PETER DEREVA
2000 GLEN ECHO RD STE 105
NASHVILLE, TN 37215-2857
Phone number: 214-687-2392
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Mailing Address
PETER DEREVA
2845 CASCADE COVE DR
LITTLE ELM, TX 75068-7607
Phone number: 214-687-2392
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