| NPI | 1073146734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAYLING LOVE C.O.O. 678-216-2718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 208200000X Plastic Surgery |
| 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery | |
| 207NS0135X Dermatology Procedural Dermatology | |
| 207Y00000X Otolaryngology | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery | |
| 207YS0123X Otolaryngology Facial Plastic Surgery | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck | |
| 261QA1903X Clinic/Center Ambulatory Surgical | |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2020-03-18 |