Healthcare Provider Details

I. General information

NPI: 1316083116
Provider Name (Legal Business Name): NONINVASIVE VASCULAR TESTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 ELLIOTT DR
YPSILANTI MI
48197-8633
US

IV. Provider business mailing address

5301 MCAULEY DR
YPSILANTI MI
48197-1051
US

V. Phone/Fax

Practice location:
  • Phone: 734-434-4200
  • Fax:
Mailing address:
  • Phone: 734-434-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name: DR. SETH W. WOLK
Title or Position: AUTHORIZED OFFICIAL
Credential: M.D.
Phone: 734-434-4200