# ADVANCED VEIN & LASER CENTER LLC

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

## Provider details

- **NPI number:** 1528088069
- **Authorized official:** MS. GAIL MARKOFF RN (ADMINISTRATOR)
- **Authorized official phone:** (937) 748-8905

## Contact information

- **Practice address:** 572 N MAIN ST, SPRINGBORO, OH 45066-9552
- **Practice address phone:** (937) 748-8905
- **Practice address fax:** (937) 748-8906
- **Mailing address:** 572 N MAIN ST, SPRINGBORO, OH 45066-9552
- **Mailing address phone:** (937) 748-8905
- **Mailing address fax:** (937) 748-8906

## Taxonomy

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

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 08/22/2020