THERESE BICKFORD-LAUB, RVT.  Therese Bickford- Laub is a  Registered Vascular Technologist and the Technical Director of our  vascular laboratory. She brings a  broad background of experience  in all aspects of vascular  tehcnology examinations. She  has been a Vascular Technologist for 21 years,  starting her career in Washington, DC where she  trained at Georgetown University Hospital. After  returning to Michigan, she worked at Detroit Medical  Center and William Beaumont Hospital before  relocating to Northern Michigan.  As a member of our  team, she is dedicated to serving patients by  performing quality vascular ultrasound examinations  with compassion and humor.    JAMES GRACY, PA-C  James Gracy, PA-C joined Great  Lakes Cardiothoracic & Vascular  Surgery in October 2007.  He  has worked side by side with  Dr. Vazales for the last ten  years.  He has been on staff at  Northern Michigan Regional  Hospital  since 1991 in the  Cardiac and Thoracic Surgery  Department.  He has been the first assistant in at least  5000 open heart surgeries and pioneered minimally  invasive endoscopic vein harvesting at Northern  Michigan Regional Hospital.  Since joining Great Lakes,  he has performed over 3000 vein procedures in our  office.    NATALIE SPIERLING, MA   Natalie Spierling joined our  practice in February 2011 and  brings with her a wealth of  experience in the medical/  surgical field.  She participates  in all aspects of patient care  including assisting our office  surgical procedures.  Natalie received her training  as a Surgical Assistant in the United States Air  Force.  Previously, she has worked as a surgical  assistant at Munson Medical Center in Neurology  and Plastic Surgery and at Northern Michigan  Regional Hospital for ten years in the  Cardiothoracic & Vascular Surgery department.   For the past nine years, she has worked as a  Medical assistant at a urology practice in Petoskey.     BRAD VAZALES, MD Dr. Vazales has been performing  heart, lung and vascular surgery  for over twenty-five years.  The last ten years he was the Medical  Director of Cardiac and Thoracic  Surgery at Northern Michigan  Regional Hospital.  Prior to that, he  was Chief of Cardiothoracic  Surgery at Lancaster General Hospital in  Pennsylvania.  He has remained on the cutting edge of new technology and surgical techniques for complex  heart and lung surgeries.  Unfortunately (though not  uncommon to this profession), Dr. Vazales is no longer  physically able to perform these complex surgeries.  A  physical disability has put a premature end to an  outstanding surgical career.  However, Dr. Vazales'  experience makes him an excellent resource for  second opinions, surgeon referrals and patient  management issues.  He continues to be very active in  the treatment of venous reflux disease.  Transition to our new practice name! These staff members plus Theresa Love, our Receptionist, Lisa Ross, our Medical Records Administrator, and Pam Trombley, Practice Manager and Biller, have all successfully transitioned from Great Lakes Cardiothoracic and  Vascular Surgery to Great Lakes Comprehensive Vein Specialists, specializing full time in the treatment of varicose vein disease.   Our staff consists of experienced professionals working closely together to deliver the  highest level health care with superior communication, compassion and respect. We are all  deeply committed to providing services that we would expect ourselves. Honesty,  openness and professionalism remain the cornerstone of how we practice medicine.   Dr. Vazales and James Gracy, PA-C, work closely together in developing and implementing  specific treatment plans for each patient balancing their individual symptoms and test  results with treatment options, personal outcome desires, insurance coverage.