| NPI | 1629321856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDSON L CROW President / Owner / Physician 218-779-9347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: ND 4766) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 27269) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |