NPI | 1326066010 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDY D PROFFITT President 251-607-0300 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
Enumeration Date | 2006-07-18 |
Last Update Date | 2015-01-27 |