| NPI | 1518967082 |
|---|---|
| Doing Business As | CENTER FOR RECONSTRUCTIVE SURGERY OF OAK LAWN |
| Entity Type | Organization |
| Authorized Contact | JENNIFER BOYD BALDOCK Officer And Authorized Official 615-234-5954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7002843) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2022-11-01 |