NPI | 1841699337 |
---|---|
Doing Business As | ACWORTH PROCEDURAL DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | JOHNATHAN L. CHAPPELL Authorized Rep/Owner 678-505-8030 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Enumeration Date | 2014-08-20 |
Last Update Date | 2014-11-07 |