Individual
ADELAIDA VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
2322 MONROE ST, PADUCAH, KY 42001-3157
(270) 305-1883
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
252056
KY
Other
Enumeration date
09/17/2016
Last updated
09/17/2016
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