Organization
CENTER FOR VEIN RESTORATION MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA THOMAS (CREDENTIALING MANAGER)
(815) 254-1761
Entity
Organization
Contact information
Practice address
401 PURDY ST STE 204, EASTON, MD 21601-4060
(855) 830-8346
Mailing address
7474 GREENWAY CENTER DR STE 1000, GREENBELT, MD 20770-3500
(815) 254-1761
(815) 254-5431
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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