| 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 |