Deactivation Date: 3/31/2023
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical Art Specialist/Technologist |
246ZA2600X |
| NPI Number | 1942859160 |
| LBN Legal business name | ESTHETICS NW SERVICES LLC |
| Authorized official | MICHELLE VARGA - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/10/2019 |
| Last updated | 09/10/2019 - About 7 years ago |
| Identifiers | n/a |
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