| NPI | 1376642082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS CLINTON LEAVENGOOD President 228-432-5955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MS 11243) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2023-03-07 |