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1962148700
VICKY LYNN VIVODA
PUEBLO, CO
NPI
1962148700
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: CO 0001495)
Enumeration Date
2022-05-05
Last Update Date
2022-05-05
Business Address
VICKY LYNN VIVODA COTA/L
2622 RIDGEWOOD LN
PUEBLO, CO 81005-3360
Phone number: 720-505-1865
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Mailing Address
VICKY LYNN VIVODA COTA/L
2622 RIDGEWOOD LN
PUEBLO, CO 81005-3360
Phone number: 720-505-1865
Copy
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