Facial Plastic & Laser Surgery

NPI #1194888677 in Peoria, Illinois

Provider Information

NPI Number
1194888677
Entity Type
Organization
Organization Name
Facial Plastic & Laser Surgery
Primary Specialty
Clinic/Center
Enumeration Date
Dec 18, 2006
Last Updated
Jul 21, 2022

Practice Location

Address
7301 N KNOXVILLE AVE
City
Peoria
ZIP Code
61614-2017
Phone
(309) 589-3233

Authorized Official

Name
MR. ROBERT J TUDOR II
Title
CHIEF EXECUTIVE OFFICER
Phone
(309) 589-8053

Specialties & Taxonomy Codes

Specialty
Clinic/Center

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