| NPI | 1801825880 |
|---|---|
| Former Legal Business Name | AESTHETIC SURGERY AT HACIENDA DEL SOL |
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN S MAXWELL Shareholder 520-382-1084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ 0110903) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2014-09-22 |