Longevity Vein Clinic LLC

NPI #1033902994 in Ballwin, Missouri

Provider Information

NPI Number: 1033902994
Entity Type: Organization
Organization Name: Longevity Vein Clinic LLC
Primary Specialty: Internal Medicine
Enumeration Date: May 23, 2025
Last Updated: May 23, 2025

Practice Location

Address: 15421 CLAYTON RD STE G1
City: Ballwin
State: Missouri
ZIP Code: 63011-3161
Phone: (314) 639-9475

Authorized Official

Name: AMEEN M BAJWA
Title: CFO
Phone: (314) 954-4005

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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