MAXIM I IVANOV

GOSHEN, IN
NPI1669560280
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy111N00000X Chiropractor
(Licence: IN  08002243A)
Enumeration Date2006-10-10
Last Update Date2007-07-08
Business Address
-- MAXIM I IVANOV D.C.
401 E MADISON ST
GOSHEN, IN 46526-3431
Phone number: 574-533-7363
Mailing Address
-- MAXIM I IVANOV D.C.
401 E MADISON ST
GOSHEN, IN 46526-3431
Phone number: 574-533-7363
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