Healthcare Provider Details

I. General information

NPI: 1881604783
Provider Name (Legal Business Name): VASCULAR DIAGNOSTIC AND TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 OFFICE PARK DR
HAMILTON OH
45013-1496
US

IV. Provider business mailing address

3200 BURNET AVE 1 RIDGEWAY
CINCINNATI OH
45229-3019
US

V. Phone/Fax

Practice location:
  • Phone: 513-844-1000
  • Fax: 513-896-3727
Mailing address:
  • Phone: 513-585-9009
  • Fax: 513-585-9373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: VERNON ROLF
Title or Position: DIRECTOR
Credential:
Phone: 513-844-1000