| NPI | 1164614137 |
|---|---|
| Other Name | EASTERN SHORE AESTHETIC SERVICES PC |
| Entity Type | Organization |
| Authorized Contact | WILLIAM RUCKER STAGGERS President 251-929-7850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2019-06-04 |