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1326462789
OCTAVIA IVY
STOCKTON, CA
NPI
1326462789
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2014-02-05
Last Update Date
2014-02-05
Business Address
-- OCTAVIA IVY
5405 N PERSHING AVE C 1
STOCKTON, CA 95207-5451
Phone number: 209-476-1959
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Mailing Address
-- OCTAVIA IVY
5405 N PERSHING AVE C 1
STOCKTON, CA 95207-5451
Phone number:
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