Organization
PERIPHERAL VASCULAR LABS OF KY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES R COLEMAN (DIRECTOR)
(606) 487-1183
Entity
Organization
Contact information
Practice address
609 MAIN ST, HAZARD, KY 41701-1381
(606) 487-1183
(606) 436-0923
Mailing address
609 MAIN ST, PO BOX 7039, HAZARD, KY 41701-1381
(606) 487-1183
(606) 436-0923
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86010972
—
KY
Enumeration date
10/17/2005
Last updated
06/06/2008
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