| NPI | 1538124094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LOVELLE-ALLEN Owner 252-384-0919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 200201488) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2020-08-22 |