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General NPI Number Information
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NPI Number | 1396962973
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Entity Type | Organization
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Legal Business Name | MERCY A. HALVERSON
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 1817 N HELM AVE SUITE 107
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City | FRESNO
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State | CA
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Zip | 93727-1631
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Country | US
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Telephone | 559-456-2334
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Fax |
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Provider Business Mailing Address
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Address Line | 1817 N HELM AVE SUITE 107
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City | FRESNO
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State | CA
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Zip | 93727-1631
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Country | US
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Telephone | 559-456-2334
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Fax | 559-456-2336
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Authorized Official
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Title or Position | OWNER
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Name | MERCY ANN HALVERSON
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Credential |
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Telephone | 559-456-2334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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