# ADVANCED SURGICAL AND RESTORATIVE CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Defatta ENT & Plastics Surgery, SC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194466235
- **Authorized official:** EMILY MOSES (CHIEF NURSING OFFICER)
- **Authorized official phone:** (715) 930-1937

## Contact information

- **Practice address:** 1470 RIVERS EDGE TRL STE B, ALTOONA, WI 54720-2755
- **Practice address phone:** (715) 379-8718
- **Mailing address:** 1470 RIVERS EDGE TRL STE B, ALTOONA, WI 54720-2755

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/05/2022
- **Last updated:** 09/02/2025