| NPI | 1912236746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE J CHASE Owner 435-634-0358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: UT 1884801205) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2015-04-30 |