| NPI | 1467074617 |
|---|---|
| Former Legal Business Name | DEWOLFE AESTHETIC SERVICES SC |
| Entity Type | Organization |
| Authorized Contact | JUDITH POLHEMUS Billing Manager 434-284-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |