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Organization
SPA MEDICAL LLC
Active
Organization
SPA MEDICAL LLC
Active
Other names
Aesthetic Center for Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH EARL HARPER MD (OWNER)
(478) 743-2472
Entity
Organization
Contact information
Practice address
455 PLUM ST, MACON, GA 31201-3368
(478) 743-2209
Mailing address
455 PLUM ST, MACON, GA 31201-3368
(478) 743-2209
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
08/05/2020
Last updated
10/06/2020
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