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Organization
VINTAGE LITHOTRIPSY, LLC
Active
Organization
VINTAGE LITHOTRIPSY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY DINH (REVENUE CYCLE MANAGER)
(520) 323-8732
Entity
Organization
Contact information
Practice address
5150 BROADWAY ST, SAN ANTONIO, TX 32304-5710
(520) 323-8732
(520) 547-1865
Mailing address
6339 E SPEEDWAY BLVD, TUCSON, AZ 85710-1147
(520) 323-8732
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/08/2017
Last updated
05/08/2017
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