Organization
AESTHETIC & LASER PLASTIC SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMAL YOUSEFI (DIRECTOR)
(703) 255-4922
Entity
Organization
Contact information
Practice address
502 MAPLE AVE W, VIENNA, VA 22180-4239
(703) 255-4922
Mailing address
502 MAPLE AVE, WEST, VIENNA, VA 22180
(703) 255-4922
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
56390-MD
VA
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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