Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1003841511 |
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| LBN Legal business name | AUGUSTA AESTHETIC SURGERY | ||||||||||||
| Authorized official | GARY WILLIAMSON - (OWNER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 07/12/2006 | ||||||||||||
| Last updated | 08/22/2020 - About 6 years ago | ||||||||||||
| Identifiers |
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