| NPI | 1467955179 |
|---|---|
| Doing Business As | SKIN CARE CENTER OF S. ILLINOIS - CENTRALIA |
| Entity Type | Organization |
| Authorized Contact | JIM FEINSTEIN Preseident/COO 763-746-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-06-16 |