NPI | 1386954956 |
---|---|
Doing Business As | CLINIC DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | BRADLEY GAIL JELLERICHS Owner 253-251-2688 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: WA 603049127) |
Enumeration Date | 2010-10-18 |
Last Update Date | 2023-12-12 |