| NPI | 1316047483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA M JONES Owner/President 800-994-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VT 0420010026) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-08-09 |