| NPI | 1871901009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI WECHSLER Billing 912-354-4969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: LA 22651) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |