| NPI | 1447454319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY VAN HOOSER MIRRO Medical Doctor, Business Owner 901-755-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2017-03-08 |