Organization
VESTIGE PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERAME TROY VANCIL (PSR)
(510) 967-5298
Entity
Organization
Contact information
Practice address
620 E PLUMB LN, RENO, NV 89502-3536
(775) 825-3043
Mailing address
620 E PLUMB LN, RENO, NV 89502-3536
(775) 825-3043
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
0804464530
NV
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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