Organization
AVITAS LLC
Active
Other names
AVITAS
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS EAGLEEYE (PRESIDENT)
(740) 214-8998
Entity
Organization
Contact information
Practice address
172 S FRIENDSHIP DR STE A, NEW CONCORD, OH 43762-9641
(740) 214-8998
Mailing address
PO BOX 894, CAMBRIDGE, OH 43725-0894
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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