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Organization
DESOTO EYE AND EAR
Active
Organization
DESOTO EYE AND EAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY SANDERS AUD (AUDIOLOGIST)
(662) 510-2138
Entity
Organization
Contact information
Practice address
5699 GETWELL RD BLDG G2, SOUTHAVEN, MS 38672-7303
(662) 510-2138
Mailing address
5699 GETWELL RD BLDG G2, SOUTHAVEN, MS 38672-7303
(662) 510-2138
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
231H00000X
Audiologist
Primary
—
—
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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