Organization
BELLISIMA LASER AESTHETICS AND WELLNESS CLINIC, L.L.C.
Active
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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