| NPI | 1356214696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY KLENKE Owner 843-815-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2025-09-24 |
| Last Update Date | 2025-09-24 |