Individual
VIVARA RAGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3054 CHERRYWOOD DR, BETTENDORF, IA 52722-7550
(573) 823-4632
Mailing address
3054 CHERRYWOOD DR, BETTENDORF, IA 52722-7550
(573) 823-4632
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/19/2020
Last updated
09/19/2020
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