INNOVAMED VEINS SC

ROCKFORD, IL
NPI1063652873
Entity TypeOrganization
Authorized ContactTRACY C BRITO
Owner
815-987-1802
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: IL  036074111)
Additional Taxonomies202K00000X 
(Licence: IL  036074111)
Enumeration Date2009-03-06
Last Update Date2009-06-04
Business Address
INNOVAMED VEINS SC
2601 N MAIN ST
ROCKFORD, IL 61103-3110
Phone number: 815-987-1802
Mailing Address
INNOVAMED VEINS SC
2601 N MAIN ST
ROCKFORD, IL 61103-3110
Phone number: 815-987-1802