# VARICOSE VEIN TREATMENT CENTER

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

## Provider details

- **NPI number:** 1033466495
- **Authorized official:** KENT A BEAMS MD (OWNER)
- **Authorized official phone:** (812) 325-2341

## Contact information

- **Practice address:** 3209 W FULLERTON PIKE, SUITE C, BLOOMINGTON, IN 47403-4060
- **Practice address phone:** (812) 325-2341
- **Mailing address:** 3209 W FULLERTON PIKE, SUITE C, BLOOMINGTON, IN 47403-4060
- **Mailing address phone:** (812) 325-2341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 202K00000X | Phlebology Physician | — | NULL | Yes |
| 202K00000X | Phlebology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/04/2012
- **Last updated:** 08/20/2012