Aesthetic Dermatology

NPI 1164748117 - Dermatology - 207N00000X

NPI Details
NPI 1164748117
Enumeration Date 04/15/2010
Last Updated 04/15/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name ATHENA ATHENA
Position OWNER
Phone (334) 273-1122
Fax
Practice Location
300 TAYLOR RD
SUITE 800
MONTGOMERY AL, 36117-3521, US
Phone (334) 273-1122
Fax
Business Location
2257 TAYLOR RD
SUITE 200
MONTGOMERY AL, 36117-7790, US
Phone
Fax
Toxanomy
Taxonomy Code 207N00000X
License State
License Number
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According to our database, Aesthetic Dermatology NPI is 1164748117, taxonomy code is 207N00000X Aesthetic Dermatology physically located at 300 Taylor Rd, Montgomery AL, 36117-3521. NPI Number 1033115704 has the healthcare provider type.

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1164748117 NPI number is provided on an as is basis without warranty of any kind. 1164748117 is maintained by the National Plan & Provider Enumeration System. The contents of Aesthetic Dermatology are for informational purposes only.