ALEX VILLAVICENCIO

FORT WAYNE, IN
NPI1053836882
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IN  71007374A)
Enumeration Date2017-08-14
Last Update Date2022-07-21
Business Address
ALEX VILLAVICENCIO NP-C
7601 W JEFFERSON BLVD
FORT WAYNE, IN 46804-4133
Phone number: 260-436-8686
Mailing Address
ALEX VILLAVICENCIO NP-C
7601 W JEFFERSON BLVD
FORT WAYNE, IN 46804-4133
Phone number: 260-436-8686
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