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Organization

VEIN CLINIC OF LAKE HAVASU

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BOBBY A SHAH MD (OWNER)
(928) 453-1800
Entity
Organization

Contact information

Practice address
2156 RUDOLPH DR, LAKE HAVASU CITY, AZ 86406-8106
(928) 453-1800
Mailing address
2156 RUDOLPH DR, LAKE HAVASU CITY, AZ 86406-8106
(928) 453-1800

Taxonomy

Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary

Other

Enumeration date
08/12/2016
Last updated
10/19/2016
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