Individual
IVAN V WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2604 JACK PINE ST, BELLEVUE, NE 68123-1513
(253) 222-3703
Mailing address
2604 JACK PINE ST, BELLEVUE, NE 68123-1513
(253) 222-3703
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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