Organization
ELITE ANTI-AGING AND VEIN CLINIC
Active
Other names
Elite Vein Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD ALBERT JOHNSON MD (OWNER)
(816) 453-0017
Entity
Organization
Contact information
Practice address
5400 N OAK TRFY, SUITE 115, KANSAS CITY, MO 64118-4688
(816) 453-0017
(816) 453-0018
Mailing address
PO BOX 901480, KANSAS CITY, MO 64190-1480
(816) 453-0017
(816) 453-0018
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2007030787
MO
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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