| NPI | 1033832530 |
|---|---|
| Other Name | LAKELANDS PLASTIC SURGERY |
| Entity Type | Organization |
| Authorized Contact | MATTHEW T LOGAN President And CEO 864-725-4253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-11-07 |