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General NPI Number Information
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NPI Number | 1548508898
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Entity Type | Organization
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Legal Business Name | VINCENT VEIN CENTER GRAND JUNCTION,PC
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 601 CENTER AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-2041
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Country | US
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Telephone | 970-263-7348
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Fax |
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Provider Business Mailing Address
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Address Line | 601 CENTER AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-2041
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Country | US
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Telephone | 970-263-7348
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Fax |
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Authorized Official
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Title or Position | BILLING
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Name | DEBBIE JOHNS
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Credential |
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Telephone | 970-254-1686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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