Provider Demographics
NPI:1033578935
Name:BACK230 VEIN & BODY LLC
Entity Type:Organization
Organization Name:BACK230 VEIN & BODY LLC
Other - Org Name:DOGWOOD VEIN INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:WESTROL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-869-8346
Mailing Address - Street 1:308 SCARBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3664
Mailing Address - Country:US
Mailing Address - Phone:864-869-8346
Mailing Address - Fax:
Practice Address - Street 1:2 MAPLE TREE CT
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4068
Practice Address - Country:US
Practice Address - Phone:864-234-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-19
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33033202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty