NPI:
1154577203
Provider Name:
CENTER FOR PLASTIC SURGERY, LLC
Former Legal Business Name: CENTER FOR PLASTIC SURGERY,LLC
Classification:
Clinic/Center - 261QA1903X
Entity Type:
Organization
Specialization: Ambulatory Surgical
CLIA Number: 13D2014600
Address:
1880 FILLMORE STREET
TWIN FALLS, ID
ZIP 83301
Phone:
(208) 735-8386
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CENTER FOR PLASTIC SURGERY, LLC is an ambulatory surgical clinic center in Twin Falls, ID. CENTER FOR PLASTIC SURGERY, LLC NPI is 1154577203. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Center For Plastic Surgery,llc.
The provider's business location address is:
1880 FILLMORE STREET
TWIN FALLS, ID
ZIP 83301-015
Phone: (208) 735-8386
Fax: (208) 734-0434
The provider's authorized official is Dell P Smith .
The authorized official title is Owner and has the following contact phone number (208) 735-8386.
The CLIA number assigned to this NPI record is 13D2014600 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 8/8/2008 and was last updated on 8/13/2008.