| NPI | 1184625634 |
|---|---|
| Former Legal Business Name | ST JOHN CLINIC PLLC |
| Entity Type | Organization |
| Authorized Contact | TANVEER ASLAM Co Owner/President 731-285-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 30495) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 34718) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2020-08-22 |