Individual
ANGEL ISOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4615 DUPREE RD., OLIVE BRANCH, MS 38654-5197
(662) 544-2536
Mailing address
4615 DUPREE RD., OLIVE BRANCH, MS 38654-5197
(662) 544-2536
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
22-1648
MS
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/15/2020
Last updated
05/02/2022
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