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1043952500
RAVEN SYMONE VEGA
LOUISVILLE, KY
NPI
1043952500
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2022-04-13
Last Update Date
2022-12-08
Business Address
RAVEN SYMONE VEGA
215 CENTRAL AVE STE 201
LOUISVILLE, KY 40208-1451
Phone number: 502-637-7678
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Mailing Address
RAVEN SYMONE VEGA
901 S 4TH ST
LOUISVILLE, KY 40203-3205
Phone number: 502-585-9911
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