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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3370933
—
TN
Enumeration date
06/13/2007
Last updated
03/08/2017
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