| NPI | 1841453594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN GEOGHEGAN Owner 480-264-6428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: AZ 36143) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-10-17 |