Organization
CENTER FOR VEIN RESTORATION AL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA THOMAS (CREDENTIALING MANAGER)
(815) 254-1761
Entity
Organization
Contact information
Practice address
3280 ROSS CLARK CIR, DOTHAN, AL 36303-3040
(855) 830-8346
(240) 473-4321
Mailing address
7474 GREENWAY CENTER DR, SUITE 1000, GREENBELT, MD 20770-3504
(855) 830-8346
(240) 965-4321
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/11/2015
Last updated
05/30/2024
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