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Organization

FACIAL PLASTIC & LASER SURGERY

Active
Other names
Facial Plastic & Laser Surgery Center, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT J TUDOR II (CHIEF EXECUTIVE OFFICER)
(309) 589-8053
Entity
Organization

Contact information

Practice address
7301 N KNOXVILLE AVE, PEORIA, IL 61614-2017
(309) 589-3233
(309) 689-0312
Mailing address
7301 N KNOXVILLE AVE, PEORIA, IL 61614-2017
(309) 589-3233
(309) 689-0312

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
IL

Other

Enumeration date
12/18/2006
Last updated
07/21/2022
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