| NPI | 1831592930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENVIA POTTER Surgical Coordinator 251-929-7850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AL 23669) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |