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1215276530
CENTER FOR COSMETIC AND LASER SURGERY, LLC
BLOOMINGTON, IL
NPI
1215276530
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Entity Type
Organization
Authorized Contact
JEFFREY S POULTER
Owner
309-663-1222
Organization Subpart ?
No
Primary Taxonomy
208200000X Plastic Surgery
(Licence: IL 036084126)
Enumeration Date
2013-02-06
Last Update Date
2013-02-06
Business Address
CENTER FOR COSMETIC AND LASER SURGERY, LLC
1505 EASTLAND DR STE 350
BLOOMINGTON, IL 61701-3534
Phone number: 309-663-1222
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Mailing Address
CENTER FOR COSMETIC AND LASER SURGERY, LLC
1505 EASTLAND DR STE 350
BLOOMINGTON, IL 61701-3534
Phone number: 309-663-1222
Copy
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