| NPI | 1568960862 |
|---|---|
| Doing Business As | MED CENTER HEALTH VEIN CLINIC |
| Entity Type | Organization |
| Authorized Contact | RONALD GENE SOWELL Exec. Vice President 270-745-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2019-09-30 |