Organization
MEDERMIS LASER CLINIC
Active
Other names
Tattoo Removal
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE LIVERMORE (CEO)
(512) 965-8189
Entity
Organization
Contact information
Practice address
2111 DICKSON DR, SUITE 20, AUSTIN, TX 78704-4796
(512) 637-5277
Mailing address
2111 DICKSON DR, SUITE 20, AUSTIN, TX 78704-4796
(512) 637-5277
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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