Individual
CYBIL VIVAS BALCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
519 GREGG AVE NW, AIKEN, SC 29801-2911
(803) 979-0187
Mailing address
302 UNIVERSITY PKWY, AIKEN, SC 29801-6302
(803) 641-5550
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
223349
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
03/18/2021
Last updated
03/18/2021
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