| Center for Plastics & Restorative Surgery | |
|
200 Saint Marys Plz Suite 201 Jefferson City MO 65101-1604 | |
| (573) 632-4325 | |
| (573) 659-2503 |
| Full Name | Center for Plastics & Restorative Surgery |
|---|---|
| Speciality | Clinic/center |
| Location | 200 Saint Marys Plz, Jefferson City, Missouri |
| Authorized Official Name and Position | Brent Van Conia (PRESIDENT) |
| Authorized Official Contact | 5737617000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center for Plastics & Restorative Surgery Po Box 1027 Jefferson City MO 65102-1027 Ph: (573) 632-4325 | Center for Plastics & Restorative Surgery 200 Saint Marys Plz Suite 201 Jefferson City MO 65101-1604 Ph: (573) 632-4325 |
| NPI Number | 1679510861 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 12/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679510861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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