NPI | 1306366885 |
---|---|
Doing Business As | ST. BERNARDS DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | JOHN LIEBLONG President 870-932-7024 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2017-06-26 |
Last Update Date | 2021-11-19 |