| NPI | 1316389836 |
|---|---|
| Doing Business As | MIDTOWN VASCULAR CENTER |
| Entity Type | Organization |
| Authorized Contact | REUBEN KRIS ELLIS Proprietor 478-250-1328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 055819) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 055819) |
| 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: GA 055819) | |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2020-11-19 |