| NPI | 1033737366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKSON CRAIG BAILEY CEO 866-649-6863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| 364SC2300X Clinical Nurse Specialist Chronic Care | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2021-04-21 |