Individual
MR. CLYDE ALLEN VANCISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-8673
(706) 787-0105
Mailing address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-8673
(706) 787-0105
Taxonomy
Speciality
Code
Description
License number
State
247000000X
Health Information Technician
Primary
—
—
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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