| Organization Name: | MIDWEST VEIN TREATMENT CLINIC INC |
| NPI Number: | 1023154333 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY MOORE (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 8101 Miller Farm Ln Suite A Centerville |
| State: | OH US |
| Postal Code: | 454587320 |
| Phone Number: | 9372810200 |
| Fax Number: | 9372810203 |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 03/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |