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General NPI Number Information
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NPI Number | 1679113047
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Entity Type | Organization
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Legal Business Name | LIPOSUCTION SOLUTIONS, LLC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 1630 MARKET CENTER BLVD STE 203
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City | O FALLON
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State | MO
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Zip | 63368-8407
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Country | US
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Telephone | 636-397-4012
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Fax | 636-278-1670
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Provider Business Mailing Address
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Address Line | 1630 MARKET CENTER BLVD STE 203
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City | O FALLON
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State | MO
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Zip | 63368-8407
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Country | US
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Telephone | 636-397-4012
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Fax | 636-278-1670
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OPERATIONS
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Name | DAWN MARIE SIMON
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Credential |
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Telephone | 636-397-4012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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