| NPI | 1356646202 |
|---|---|
| Doing Business As | PROVIDENCE INLAND VASCULAR INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | ANSELMO NUNEZ Chief Executive 509-474-6616 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA 600503827) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2011-03-24 |