| NPI | 1821271172 |
|---|---|
| Doing Business As | CRYSTAL COAST PLASTIC SURGERY |
| Entity Type | Organization |
| Authorized Contact | ANTONIO MIGUEL CARBONELL President 252-247-0094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NC 27897) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2007-12-10 |