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Organization

INNSBROOK PLASTIC SURGERY LLC

Active
Parent organization
INNSBROOK PLASTIC SURGERY LLC
Other names
Innsbrook Plastic Surgery
Organization subpart
Yes

Provider details

NPI number
Legal business name
INNSBROOK PLASTIC SURGERY LLC
Authorized official
LOUISE DIANE FERLAND MD (BUISNESS OWNER)
(804) 346-8700
Entity
Organization

Contact information

Practice address
4050 INNSLAKE DR, SUITE 310, GLEN ALLEN, VA 23060-3327
(804) 346-8700
(804) 346-1230
Mailing address
4050 INNSLAKE DRIVE, SUITE 310, GLEN ALLEN, VA 23060-3327
(804) 346-8700
(804) 346-1230

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0101223586
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
246429
BCBS AMB SURGERY CENTER #
VA
Enumeration date
03/27/2007
Last updated
07/10/2008
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