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General NPI Number Information
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NPI Number | 1194771451
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Entity Type | Organization
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Legal Business Name | CENTER FOR ADVANCED VEIN CARE PLLC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 3513 GRAYSTONE PL
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City | CONOVER
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State | NC
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Zip | 28613-8201
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Country | US
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Telephone | 828-322-8485
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Fax | 828-322-5039
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Provider Business Mailing Address
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Address Line | 3513 GRAYSTONE PL
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City | CONOVER
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State | NC
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Zip | 28613-8201
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Country | US
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Telephone | 828-322-8485
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Fax | 828-322-5039
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Authorized Official
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Title or Position | OWNER
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Name | DR. AARON D THOMPSON
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Credential | MD
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Telephone | 828-322-8485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 94-01070
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License Number State | NC
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