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1982010716
RIVERSIDE DERMATOLOGY AND AESTHETIC CENTER, PC
COLUMBUS, GA
NPI
1982010716
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Entity Type
Organization
Authorized Contact
JACQUELINE NICOLE FUSSELL
Physician
706-257-4189
Organization Subpart ?
No
Primary Taxonomy
207N00000X Dermatology
(Licence: GA 70111)
Enumeration Date
2014-07-01
Last Update Date
2014-07-01
Business Address
RIVERSIDE DERMATOLOGY AND AESTHETIC CENTER, PC
2045 CENTRE STONE CT SUITE B
COLUMBUS, GA 31904-4571
Phone number: 706-257-4189
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Mailing Address
RIVERSIDE DERMATOLOGY AND AESTHETIC CENTER, PC
2045 CENTRE STONE CT SUITE B
COLUMBUS, GA 31904-4571
Phone number: 706-257-4189
Copy
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