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Organization

ASPIRE PLASTIC SURGERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN J LEE M.D. (OWNER/PROVIDER)
(260) 424-9192
Entity
Organization

Contact information

Practice address
7910 W JEFFERSON BLVD STE 212, FORT WAYNE, IN 46804-4159
(260) 424-9192
Mailing address
7910 W JEFFERSON BLVD STE 212, FORT WAYNE, IN 46804-4159
(260) 424-9192

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01040298A
IN

Other

Enumeration date
03/02/2012
Last updated
03/02/2012
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