# MANSFIELD PLASTIC SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417191636
- **Authorized official:** DR. RAFAEL E. VILLALOBOS D.O. (OWNER)
- **Authorized official phone:** (419) 756-1125

## Contact information

- **Practice address:** 370 CLINE AVE, MANSFIELD, OH 44907-1057
- **Practice address phone:** (419) 756-1125
- **Practice address fax:** (419) 756-1825
- **Mailing address:** 370 CLINE AVE, MANSFIELD, OH 44907-1057
- **Mailing address phone:** (419) 756-1125
- **Mailing address fax:** (419) 756-1825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 34005536 | OH | Yes |

## Other

- **Enumeration date:** 05/01/2009
- **Last updated:** 05/01/2009