Provider Demographics
NPI:1003590167
Name:PRECISE BIOSCIENCE, LLC
Entity Type:Organization
Organization Name:PRECISE BIOSCIENCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:MAURELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-207-8598
Mailing Address - Street 1:7630 PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5607
Mailing Address - Country:US
Mailing Address - Phone:630-207-8598
Mailing Address - Fax:888-248-8698
Practice Address - Street 1:7630 PLAZA CT
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-5607
Practice Address - Country:US
Practice Address - Phone:630-207-8598
Practice Address - Fax:888-248-8698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty