| NPI | 1841234069 |
|---|---|
| Former Legal Business Name | VEIN CLINICS NORTHWEST, PLLC |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS STAFFORD President 208-676-0104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2017-01-25 |