Individual
DR. THIERRY DERVIEUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD DABCC
Contact information
Practice address
1261 LIBERTY WAY, VISTA, CA 92081-8356
(858) 784-1673
Mailing address
1261 LIBERTY WAY, VISTA, CA 92081-8356
(858) 784-1673
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
DERVT1
NY
Other
Enumeration date
07/09/2016
Last updated
07/09/2016
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