Individual
JUDY STOVALL RIVENBARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
555 STOCKTON STREET, JACKSONVILLE, FL 32204
(800) 888-8776
Mailing address
POST OFFICE BOX 15580, FERNANDIDA BEACH, FL 32035
(800) 888-8776
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
ME81633
FL
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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