| NPI | 1811937402 |
|---|---|
| Doing Business As | VEIN CARE PAVILION OF THE SOUTH |
| Entity Type | Organization |
| Authorized Contact | STEVEN M ROTH Sole Member/President 706-854-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X (Licence: GA 048566) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-05-23 |