| NPI | 1013997204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRIAN LOUTON Owner 814-949-7280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: PA MD045155E) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2020-08-22 |