| NPI | 1457564213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDALLA Z BANDAK Owner 304-925-4665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WV 21839) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |