Individual
VICTORIA ROSE VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
402 6TH ST, RUPERT, ID 83350-1619
(208) 650-7941
Mailing address
478 FILMORE AVE, POCATELLO, ID 83201-3811
(859) 321-9421
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/04/2022
Last updated
09/06/2022
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