| NPI | 1225534530 |
|---|---|
| Former Legal Business Name | MAGNOLIA ALLERGY CLINIC LLC |
| Entity Type | Organization |
| Authorized Contact | LAN ZHOU Physician 601-519-9562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MS 22223) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2024-01-24 |