Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Plastic and Reconstructive Surgery |
2086S0122X | 02 | Physician/General Surgery |
| NPI # | 1447043419 |
| LBN Legal business name | BELLAVA MEDSPA INC |
| Authorized official | NICK ADAMS - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/23/2025 |
| Last updated | 05/23/2025 - More than a year ago |
| Identifiers | n/a |
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