Provider Demographics
NPI:1679113047
Name:LIPOSUCTION SOLUTIONS, LLC
Entity Type:Organization
Organization Name:LIPOSUCTION SOLUTIONS, LLC
Other - Org Name:LIPEDEMA SURGICAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-397-4012
Mailing Address - Street 1:1630 MARKET CENTER BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8407
Mailing Address - Country:US
Mailing Address - Phone:636-397-4012
Mailing Address - Fax:636-278-1670
Practice Address - Street 1:1630 MARKET CENTER BLVD STE 203
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8407
Practice Address - Country:US
Practice Address - Phone:636-397-4012
Practice Address - Fax:636-278-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty