Organization
SPA MEDICAL LLC
Active
Other names
Aesthetic Center for Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH EARL HARPER MD (OWNER)
(478) 743-2472
Entity
Organization
Contact information
Practice address
455 PLUM ST, MACON, GA 31201-3368
(478) 743-2209
Mailing address
455 PLUM ST, MACON, GA 31201-3368
(478) 743-2209
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
08/05/2020
Last updated
10/06/2020
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