| NPI | 1851009971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY POLHEMUS Practice Manager 434-284-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2022-11-08 |
| Last Update Date | 2022-11-08 |