| NPI | 1194888677 |
|---|---|
| Other Name | FACIAL PLASTIC & LASER SURGERY CENTER, LLC |
| Entity Type | Organization |
| Authorized Contact | ROBERT J TUDOR Chief Executive Officer 309-589-8053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2022-07-21 |