| NPI | 1154342350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL M TKACH Owner 270-444-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2010-12-03 |