Organization
CENTRIC OUTPATIENT CATH LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJEEV DHARI RAVIPUDI MD (OWNER)
(626) 394-6299
Entity
Organization
Contact information
Practice address
2103 SILVA LN, MOBERLY, MO 65270-3660
(660) 616-0022
Mailing address
2103 SILVA LN, MOBERLY, MO 65270-3660
(660) 616-0022
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
2002015751
MO
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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