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General NPI Number Information
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NPI Number | 1528053469
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR AESTHETICS & PLASTIC SURGERY S.C.
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 425 S COMMERCIAL ST
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City | NEENAH
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State | WI
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Zip | 54956-2526
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Country | US
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Telephone | 920-725-0700
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Fax | 920-725-7978
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Provider Business Mailing Address
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Address Line | 425 S COMMERCIAL ST
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City | NEENAH
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State | WI
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Zip | 54956-2526
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Country | US
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Telephone | 920-725-0700
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Fax | 920-725-7978
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Authorized Official
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Title or Position | OWNER
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Name | TODD M VAN YE
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Credential | MD
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Telephone | 920-725-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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