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Organization
VEIN CLINIC LLC
Active
Organization
VEIN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT A BEAMS MD (OWNER)
(812) 325-3275
Entity
Organization
Contact information
Practice address
3209 W FULLERTON PIKE, SUITE G, BLOOMINGTON, IN 47403-4060
(812) 325-3275
Mailing address
3209 W FULLERTON PIKE, SUITE G, BLOOMINGTON, IN 47403-4060
(812) 325-3275
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
NULL
202K00000X
Phlebology Physician
Primary
—
—
Other
Enumeration date
09/10/2012
Last updated
04/21/2015
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