Organization
CENTER FOR VEIN RESTORATION IN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA THOMAS (CREDENTIALING MANAGER)
(815) 254-1761
Entity
Organization
Contact information
Practice address
33 E COUNTY LINE RD STE D, GREENWOOD, IN 46143-1078
(855) 830-8346
Mailing address
7474 GREENWAY CENTER DR, SUITE 1000, GREENBELT, MD 20770-3504
(240) 965-3258
(240) 473-4321
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
02/23/2016
Last updated
06/18/2024
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