Organization
PREMIER VASCULAR AND VEIN SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE DOLE (MANGER)
(209) 575-4575
Entity
Organization
Contact information
Practice address
1512 COLORADO AVE, TURLOCK, CA 95380-2711
(209) 668-8030
Mailing address
PO BOX 4978, MODESTO, CA 95352-4978
(209) 575-4575
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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