| NPI | 1255601613 |
|---|---|
| Doing Business As | HIGH DESERT VEIN CENTER |
| Entity Type | Organization |
| Authorized Contact | KALE D BODILY President 928-757-0620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 42974) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AZ 42974) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-03-02 |