| NPI | 1982854568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E BISSECK Physician/Owner 912-681-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 061556) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2012-10-16 |