Center For Plastics & Restorative Surgery | |
200 Saint Marys Plz Suite 201 Jefferson City MO 65101-1604 | |
(573) 632-4325 | |
(573) 659-2503 |
Full Name | Center For Plastics & Restorative Surgery |
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Speciality | Clinic/center |
Location | 200 Saint Marys Plz, Jefferson City, Missouri |
Authorized Official Name and Position | Brent Van Conia (PRESIDENT) |
Authorized Official Contact | 5737617000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Center For Plastics & Restorative Surgery Po Box 1027 Jefferson City MO 65102-1027 Ph: (573) 632-4325 | Center For Plastics & Restorative Surgery 200 Saint Marys Plz Suite 201 Jefferson City MO 65101-1604 Ph: (573) 632-4325 |
NPI Number | 1679510861 |
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Provider Enumeration Date | 05/31/2006 |
Last Update Date | 12/13/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679510861 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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