| NPI | 1073032579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN BRUCE LOBER Owner 706-369-8440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 033386) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2021-04-14 |