Provider Demographics
NPI:1609607555
Name:VASCULAR WELLNESS CENTER
Entity type:Organization
Organization Name:VASCULAR WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:C
Authorized Official - Last Name:NJOKU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-688-8140
Mailing Address - Street 1:PO BOX 673121
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30006-0053
Mailing Address - Country:US
Mailing Address - Phone:678-688-8140
Mailing Address - Fax:470-204-8997
Practice Address - Street 1:614 S 8TH ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4214
Practice Address - Country:US
Practice Address - Phone:678-688-8140
Practice Address - Fax:470-204-8997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty