| NPI | 1689360117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA OLSON Owner 480-466-7355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 208200000X Plastic Surgery |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-10-02 |