Organization
EASTERN SHORE COSMETIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENVIA POTTER (SURGICAL COORDINATOR)
(251) 929-7850
Entity
Organization
Contact information
Practice address
7541 CIPRIANO CT, FAIRHOPE, AL 36532-3029
(251) 929-7850
(251) 929-2500
Mailing address
7541 CIPRIANO CT, FAIRHOPE, AL 36532-3029
(251) 929-7850
(251) 929-2500
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
23669
AL
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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