NPI | 1033651203 |
---|---|
Doing Business As | REFLECTIONS IMAGE CENTER & SKINCARE INSTITUTE |
Entity Type | Organization |
Authorized Contact | LASONDRA GRAY Managing Member 571-337-3870 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173992) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 28154063A) |
Enumeration Date | 2016-11-04 |
Last Update Date | 2016-11-04 |