SearchSouth Dakota1710I1003X

Ivan Vicente, IDMT

NPI 1710201553 · on the registry since 2010

Practice

Address
433 Black Elk Ct
Ellsworth Afb, SD 57706
Phone
(605) 521-3502

Registry record

Primary taxonomy
1710I1003X
1710I1003X
Sex
Male
Record last updated
2010-03-23

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in South Dakota