Southern Allergy and Medical Clinic, Inc.
NPI #1417513177 in New Tazewell, Tennessee
Provider Information
- NPI Number
- 1417513177
- Entity Type
- Organization
- Organization Name
- Southern Allergy and Medical Clinic, Inc.
- Primary Specialty
- Allergy & Immunology - Allergy
- Enumeration Date
- May 17, 2019
- Last Updated
- May 17, 2019
Practice Location
- Address
- 109 MAIN ST
- City
- New Tazewell
- State
- Tennessee
- ZIP Code
- 37825-6635
- Phone
- (423) 259-5704
Authorized Official
- Name
- SASHA LASHEA' BUSSELL
- Title
- OWNER
- Phone
- (423) 489-5841
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
| Physician Assistant |
| Allergy & Immunology - Allergy — Allergy |
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