Provider Demographics
NPI:1639243389
Name:NON-INVASIVE VASCULAR SOLUTION
Entity Type:Organization
Organization Name:NON-INVASIVE VASCULAR SOLUTION
Other - Org Name:NVS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-684-7255
Mailing Address - Street 1:1175 W WICKENBURG WAY STE 4
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-2262
Mailing Address - Country:US
Mailing Address - Phone:928-684-7255
Mailing Address - Fax:928-684-7299
Practice Address - Street 1:1175 W WICKENBURG WAY STE 4
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-2262
Practice Address - Country:US
Practice Address - Phone:928-684-7255
Practice Address - Fax:928-684-7299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZO468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTIN
AZZ83692Medicare ID - Type Unspecified