| Organization Name: | LASER AND VEIN CENTER PLLC |
| NPI Number: | 1043322811 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA D WHITE (OFFICE MANAGER) |
| Mailing Address: | 608 Northwest Blvd Suite 301 Coeur D Alene |
| State: | ID US |
| Postal Code: | 838142174 |
| Phone Number: | 2086768346 |
| Fax Number: | 2086645345 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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. |