| NPI | 1144636911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BELLEAU Member 931-645-5689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2022-01-31 |