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Individual

KAREN VICKERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5535 S WILLIAMSON BLVD, STE 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
Mailing address
507 NEW MEXICO AVE, LAS VEGAS, NM 87701-3238

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-340
NM

Other

Enumeration date
03/14/2012
Last updated
03/14/2012
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