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1104514827
IVAN VIGOA
FLAGSTAFF, AZ
NPI
1104514827
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-05-01
Last Update Date
2023-05-01
Business Address
IVAN VIGOA
2920 N 4TH ST
FLAGSTAFF, AZ 86004-1816
Phone number: 928-522-9400
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Mailing Address
IVAN VIGOA
7520 OMNI LN APT 301
FORT MYERS, FL 33905-5477
Phone number: 813-400-6742
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