NPI | 1407992373 |
---|---|
Doing Business As | REBE SKIN AND VEIN CLINIC |
Entity Type | Organization |
Authorized Contact | RONALD J KOLEGRAFF Owner And Provider 712-332-6001 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: IA 24582) |
Additional Taxonomies | 202K00000X (Licence: IA 24582) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2022-04-09 |