| 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 |