Organization
VASCULAR LAB ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILMAN P PETERSON (MD)
(270) 651-8328
Entity
Organization
Contact information
Practice address
1505 BRAVO BLVD, GLASGOW, KY 42141-3478
(270) 651-8328
Mailing address
PO BOX 694, GLASGOW, KY 42142-0694
(270) 651-8328
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64200173
—
KY
Enumeration date
01/17/2007
Last updated
06/27/2008
Update your record
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