Vein Care Pavilion of the South

NPI #1144569757 in Germantown, Wisconsin

Provider Information

NPI Number: 1144569757
Entity Type: Organization
Organization Name: Vein Care Pavilion of the South
Primary Specialty: Surgery
Enumeration Date: Feb 4, 2013
Last Updated: Jul 16, 2013

Practice Location

Address: W178N9912 RIVERCREST DR
Address 2: SUITE 102
City: Germantown
State: Wisconsin
ZIP Code: 53022-4645
Phone: (262) 672-6900

Authorized Official

Name: LORI DAVIS
Title: MANAGING MEMBER
Phone: (706) 951-1998

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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