| NPI | 1629889308 |
|---|---|
| Doing Business As | TIDEWATER ALLERY AND ASTHMA |
| Entity Type | Organization |
| Authorized Contact | JEREMY RAY OWENS Owner 757-572-6052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-04-03 |