| NPI | 1376949396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SHAWN BRAUER President/Owner 270-929-7977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KY 41114) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2015-02-28 |