Organization · Type 2 NPI

Snake River Plastic Surgery LLC

Specialist · Jackson, WY

NPI number 1104137074 Active

Practice location

555 E. Broadway, Suite 212
Jackson, WY 83001

Mailing address

PO Box 2862
Jackson, WY 83001-2862

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X2735A (WY)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1104137074

Snake River Plastic Surgery LLC's National Provider Identifier is 1104137074, issued on Jun 25, 2010. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Jackson, WY. The record was last updated on Jun 25, 2010.