Organization
AV360 MIDWEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER SIMON VASILESKI (PRESIDENT)
(224) 249-1972
Entity
Organization
Contact information
Practice address
4932 KIRBY RD, LAWRENCEBURG, IN 47025-8227
(224) 249-1972
Mailing address
4932 KIRBY RD, LAWRENCEBURG, IN 47025-8227
(224) 249-1972
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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