| NPI | 1710756390 |
|---|---|
| Doing Business As | THE BOTOX SPOT |
| Doing Business As | THE BOTOX SPOT PHYSICIAN ASSISTANT CORPORATION |
| Entity Type | Organization |
| Authorized Contact | ANDREW RUSS Owner 909-752-6869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2023-12-25 |
| Last Update Date | 2023-12-25 |