# MIDWEST VEIN TREATMENT CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023154333
- **Authorized official:** NANCY MOORE (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (512) 342-0455

## Contact information

- **Practice address:** 8101 MILLER FARM LN, SUITE A, CENTERVILLE, OH 45458-7320
- **Practice address phone:** (937) 281-0200
- **Practice address fax:** (937) 281-0203
- **Mailing address:** 8101 MILLER FARM LN, SUITE A, CENTERVILLE, OH 45458-7320
- **Mailing address phone:** (937) 281-0200
- **Mailing address fax:** (937) 281-0203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | OH | Yes |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 03/25/2008