Organization · NPI-2

Appalchain Skin And Lasar Dba Ageless Skin And Laser

Clinic/Center · Johnson City, TN

NPI number1154613511
StatusActive
Last updated in NPPESMay 4, 2011

Details

NPI
1154613511
Entity type
Organization (NPI-2)
Legal business name
Appalchain Skin And Lasar Dba Ageless Skin And Laser
Organization subpart
No
Enumeration date
May 4, 2011
Last updated
May 4, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/CenterMDO24272TNYes

Practice location

303 Med Tech Pkwy
Suite 110
Johnson City, TN 37604-2364

Phone 423-953-5300

Mailing address

303 Med Tech Pkwy
Suite 110
Johnson City, TN 37604-2364

Phone 423-953-5300

Authorized official

Marion Dean Mclaughlin
President
4239535300

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