| NPI | 1720354046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W MOBLEY Medical Director 904-647-6485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME20849) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |