Individual
JOSEFINA CYNTHIA VANDIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1395 JUNGERMANN RD, SAINT PETERS, MO 63376-7369
(636) 485-7606
Mailing address
19501 E 390 RD, CHELSEA, OK 74016-3028
(918) 541-4097
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
000000000000
OK
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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