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General NPI Number Information
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NPI Number | 1851246870
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Entity Type | Organization
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Legal Business Name | MANA VEIN, LLC
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 18555 N 79TH AVE STE B101
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City | GLENDALE
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State | AZ
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Zip | 85308-8372
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Country | US
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Telephone | 623-292-2272
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Fax | 623-292-2334
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Provider Business Mailing Address
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Address Line | 18555 N 79TH AVE STE B101
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City | GLENDALE
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State | AZ
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Zip | 85308-8372
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Country | US
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Telephone | 623-292-2272
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Fax | 623-292-2334
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Authorized Official
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Title or Position | VASCULAR SURGEON
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Name | DR. LANNERY SIOELI LAUVAO
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Credential | MD
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Telephone | 623-292-2272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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