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Contact Information

LIFT AESTHETIC SURGERY
4700 NICOLE CT
MISSOULA, MT59803-2792
 Phone: 215-990-1851
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for LIFT AESTHETIC SURGERY

NPI # 1063921260
LBN Legal business name LIFT AESTHETIC SURGERY
Authorized official RYAN MARSHALL - (SURGEON/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/20/2017
Last updated 07/21/2022 - About 4 years ago
Identifiers
MT License # 35293
MT Medicaid 1982855334
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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