| 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 |