Individual
MR. WALTER GLENN VIVIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 MARKET ST, MCKEESPORT, PA 15132-2726
(412) 672-3400
(412) 672-3456
Mailing address
500 MARKET ST, MCKEESPORT, PA 15132-2726
(412) 672-3400
(412) 672-3456
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/12/2021
Last updated
02/12/2021
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