| NPI | 1467641381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON L SMITH Owner/President 706-235-7711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: GA 032302) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2011-10-19 |