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Organization
EAST MEMPHIS ALLERGY AND ASTHMA
Active
Organization
EAST MEMPHIS ALLERGY AND ASTHMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETTY VAN HOOSER MIRRO M.D. (MEDICAL DOCTOR, BUSINESS OWNER)
(901) 755-0550
Entity
Organization
Contact information
Practice address
3085 FOUNTAINSIDE DR, SUITE 202, GERMANTOWN, TN 38138-7842
(901) 755-0550
(901) 755-0474
Mailing address
3085 FOUNTAINSIDE DR, SUITE 202, GERMANTOWN, TN 38138-7842
(901) 755-0550
(901) 755-0474
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
NULL
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Enumeration date
06/13/2007
Last updated
03/08/2017
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