Individual
VICTOR KEESEE VA'SQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1606 N 7TH ST STE 200, TERRE HAUTE, IN 47804-2706
(812) 238-7631
(812) 238-7003
Mailing address
1606 N 7TH ST STE 200, TERRE HAUTE, IN 47804-2706
(812) 238-7631
(812) 238-7003
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11022275A
IN
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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