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Individual

MR. ANTHONY K. MIKASOBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BSMT, AMT, ASCP

Contact information

Practice address
9409 WHITTINGHAM DR, BRENTWOOD, TN 37027-8460
(615) 472-8312
(615) 472-8312
Mailing address
PO BOX 22043, NASHVILLE, TN 37202-2043
(615) 472-8312
(615) 472-8312

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
22459
TN
291U00000X
Clinical Medical Laboratory
3653
PR

Other

Enumeration date
02/20/2009
Last updated
02/20/2009
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