| NPI | 1316358385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM POLLEY President/Plastic Surgeon 708-203-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301403808) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-06-19 |