| NPI | 1356007264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH CRANDALL President 706-736-1830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 208200000X Plastic Surgery |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2021-11-15 |