Organization
ADVANCED SURGICAL AND RESTORATIVE CARE LLC
Active
Other names
Defatta ENT & Plastics Surgery, SC
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY MOSES (CHIEF NURSING OFFICER)
(715) 930-1937
Entity
Organization
Contact information
Practice address
1470 RIVERS EDGE TRL STE B, ALTOONA, WI 54720-2755
(715) 379-8718
Mailing address
1470 RIVERS EDGE TRL STE B, ALTOONA, WI 54720-2755
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
09/02/2025
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