NPI | 1063564664 |
---|---|
Doing Business As | EASTSIDE DERMATOLOGY & SKIN CARE CENTER, EASTSIDE DERMATOLOGY OF HILLA |
Entity Type | Organization |
Authorized Contact | ALAN J PARKS President 614-863-3222 |
Organization Subpart ? | No |
Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: OH 35054686) |
Enumeration Date | 2007-01-17 |
Last Update Date | 2008-10-16 |