Organization
VARICOSE VEIN TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT A BEAMS MD (OWNER)
(812) 325-2341
Entity
Organization
Contact information
Practice address
3209 W FULLERTON PIKE, SUITE C, BLOOMINGTON, IN 47403-4060
(812) 325-2341
Mailing address
3209 W FULLERTON PIKE, SUITE C, BLOOMINGTON, IN 47403-4060
(812) 325-2341
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
Other
Enumeration date
08/04/2012
Last updated
08/20/2012
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