Provider Demographics
NPI:1861828220
Name:PEREZ, ELVIA (CMT)
Entity Type:Individual
Prefix:MS
First Name:ELVIA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 JAMESON ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-1488
Mailing Address - Country:US
Mailing Address - Phone:612-978-1018
Mailing Address - Fax:
Practice Address - Street 1:2526 HENNEPIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-3564
Practice Address - Country:US
Practice Address - Phone:612-616-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist