NPI: 1386297919 · MARRERO, LA 70072 · Clinical Pathology/Laboratory Medicine Physician · NPI assigned 07/23/2019
| Authorized Official | JOLLY, TARUN (OWNER) |
| NPI Enumeration Date | 07/23/2019 |
Other providers sharing the same authorized official: JOLLY, TARUN
| Provider | City | State | Total Paid |
|---|---|---|---|
| PROVISTA HEALTH, LLC | SCOTTSDALE | AZ | $105K |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 219 | $0.00 |