| NPI | 1023429818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN M SHOWALTER President/CEO 434-260-5130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: VA 0101255390) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-08-26 |