| NPI | 1356930788 |
|---|---|
| Former Legal Business Name | PENINSULA PLASTIC SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | JOHN PITMAN President 757-229-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2021-01-11 |