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1023387230
KENNETH VICKERS
WACO, TX
NPI
1023387230
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: TX 703452)
Enumeration Date
2011-12-16
Last Update Date
2011-12-16
Business Address
-- KENNETH VICKERS CRNA
100 HILLCREST MEDICAL BLVD
WACO, TX 76712-8897
Phone number: 254-230-1509
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Mailing Address
-- KENNETH VICKERS CRNA
100 HILLCREST MEDICAL BLVD
WACO, TX 76712-8897
Phone number: 254-230-1509
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