Organization
PLASTIC SURGERY OPERATIVE SUITE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY PARKS (PRACTICE ADMINISTRATOR)
(229) 242-3002
Entity
Organization
Contact information
Practice address
230 NORTHSIDE DR, VALDOSTA, GA 31602-1858
(229) 242-3002
Mailing address
230 NORTHSIDE DR, VALDOSTA, GA 31602-1858
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/26/2007
Last updated
05/05/2015
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