CENTER FOR VEIN RESTORATION AL LLC NPI 1164897427

NPI Information

CENTER FOR VEIN RESTORATION AL LLC is a vascular surgery surgery in Dothan, AL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. CENTER FOR VEIN RESTORATION AL LLC NPI is 1164897427. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3280 ROSS CLARK CIR
DOTHAN, AL
ZIP 36303-040
Phone: (855) 830-8346
Fax: (240) 473-4321

The provider's authorized official is Lorena Thomas .
The authorized official title is Credentialing Manager and has the following contact phone number (815) 254-1761.

The CLIA number assigned to this NPI record is 01D2232336 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2015 and was last updated on 12/11/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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