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1093260747
JACKIE RIVERA
COLUMBIA, MO
NPI
1093260747
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MO 2010009084)
Enumeration Date
2016-08-23
Last Update Date
2016-08-23
Business Address
-- JACKIE RIVERA LPN
807 N PROVIDENCE RD
COLUMBIA, MO 65203-4359
Phone number: 573-443-8706
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Mailing Address
-- JACKIE RIVERA LPN
807 N PROVIDENCE RD
COLUMBIA, MO 65203-4359
Phone number: 573-443-8706
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