| NPI | 1922642412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY HARBISON Practice Administrator 402-882-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |