| NPI | 1083988166 |
|---|---|
| Doing Business As | PLASTIC/RECON ASSOC OF FCCC, MGI |
| Entity Type | Organization |
| Authorized Contact | TONYA WOODARD Credentialing/Manager 215-707-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 208200000X Plastic Surgery |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2018-06-14 |