Organization
BELLISIMA LASER AESTHETICS AND WELLNESS CLINIC, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTORIA ZAVALA M.D. (MEDICAL DOCTOR)
(618) 751-4121
Entity
Organization
Contact information
Practice address
1001 E MAIN ST, SUITE 4D, CARBONDALE, IL 62901-3100
(618) 751-4121
Mailing address
1001 E MAIN ST, SUITE 4D, CARBONDALE, IL 62901-3100
(618) 751-4121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
336.088977
IL
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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