Organization
JACRIC
Active
Other names
The Vein Center and Medspa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J. LOGES III M.D. (PARTNER)
(330) 629-9400
Entity
Organization
Contact information
Practice address
965 WINDHAM CT, SUITE 2, BOARDMAN, OH 44512-5088
(330) 629-9400
(330) 629-9441
Mailing address
965 WINDHAM CT, SUITE 2, BOARDMAN, OH 44512-5088
(330) 629-9400
(330) 629-9441
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
35.070443
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0293865
—
OH
Enumeration date
07/31/2013
Last updated
09/04/2013
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