NPI | 1336912021 |
---|---|
Doing Business As | AVENUE AESTHETIC AND RECONSTRUCTIVE SURGERY |
Entity Type | Organization |
Authorized Contact | JESSICA BAVANI Office Manager 706-363-0256 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Enumeration Date | 2023-11-03 |
Last Update Date | 2023-11-03 |