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General NPI Number Information
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NPI Number | 1588527592
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Entity Type | Organization
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Legal Business Name | PRECISION VEIN & VASCULAR LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 8 COOPER DR
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City | IDAHO CITY
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State | ID
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Zip | 83631-4148
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Country | US
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Telephone | 208-982-6734
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Fax |
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Provider Business Mailing Address
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Address Line | 368 E RIVERSIDE DR STE 3A
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City | ST GEORGE
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State | UT
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Zip | 84790-7067
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Country | US
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Telephone | 804-438-4259
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRISTINA PIKE
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Credential | CPC
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Telephone | 208-982-6734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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