| NPI | 1770921454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KEANE Owner 678-448-8276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: AR E-6521) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |