| NPI | 1568293934 |
|---|---|
| Former Legal Business Name | ADVANCED VASCULAR |
| Entity Type | Organization |
| Authorized Contact | MARLA BANNING Nurse 505-712-9621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-08-08 |
| Last Update Date | 2024-08-08 |