Organization
ER PLASTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHELE L BANASIAK (MANAGER)
(480) 657-2000
Entity
Organization
Contact information
Practice address
5010 E SHEA BLVD, SUITE 175, SCOTTSDALE, AZ 85254-4681
(480) 657-2000
(480) 657-2011
Mailing address
10645 N TATUM BLVD, SUITE 200 611, PHOENIX, AZ 85028-3068
(480) 657-2000
(480) 657-2011
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
AZ
Other
Enumeration date
01/22/2016
Last updated
01/22/2016
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