Provider Demographics
NPI:1932678281
Name:VEIN CENTER AT ALLURE MEDICAL SPA, PLLC
Entity Type:Organization
Organization Name:VEIN CENTER AT ALLURE MEDICAL SPA, PLLC
Other - Org Name:CHARLES MOK DO
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RYNKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-992-8300
Mailing Address - Street 1:8180 26 MILE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-5139
Mailing Address - Country:US
Mailing Address - Phone:586-992-8300
Mailing Address - Fax:586-992-2830
Practice Address - Street 1:8180 26 MILE RD STE 300
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-5139
Practice Address - Country:US
Practice Address - Phone:586-992-8300
Practice Address - Fax:586-992-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical