IVAN VIVANCO

CHATSWORTH, CA
NPI1700423712
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2019-12-09
Last Update Date2019-12-09
Business Address
IVAN VIVANCO
21000 PLUMMER ST
CHATSWORTH, CA 91311-4903
Phone number: 661-348-5492
Mailing Address
IVAN VIVANCO
21000 PLUMMER ST
CHATSWORTH, CA 91311-4903
Phone number:
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