| NPI | 1205008489 |
|---|---|
| Doing Business As | TUXEDO AESTHETIC SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | RICHARD CRAWFORD MATTISON Owner 404-812-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 011627) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-07-01 |