| NPI | 1427668342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH EARL HARPER Owner 478-743-2472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-10-06 |