| NPI | 1770593394 |
|---|---|
| Other Name | PLASTIC SURGERY |
| Entity Type | Organization |
| Authorized Contact | STACY GRECO Payer Enrollment Manager 223-341-8516 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-11-21 |