| NPI | 1760787626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD EADES Owner 520-323-6994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AZ 19656) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2021-06-28 |