| NPI | 1912231895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM B NICKELL Medical Director 205-980-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AL 3370) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: AL 3370) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2009-09-25 |