Individual
KENZIE K VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1433 N 6TH 1/2 ST, TERRE HAUTE, IN 47807-1037
(812) 237-7609
Mailing address
1433 N 6TH 1/2 ST, TERRE HAUTE, IN 47807-1037
(812) 237-7609
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
12/11/2024
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