NPI | 1922483205 |
---|---|
Doing Business As | BLUE DIAMOND MED SPA |
Entity Type | Organization |
Authorized Contact | JONAS CRAFTS Owner 210-494-2820 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2015-07-28 |
Last Update Date | 2015-07-28 |