| NPI | 1790493336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKILI TREADWAY Owner 731-671-8273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |