| NPI | 1356648216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEAH MICHELLE PHILLIPS Credentialing Manager 901-205-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2023-09-27 |