Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | PT02055 | RI |
N | 213ES0000X | Sports Medicine | PT02055 | RI |
Y | 225100000X | Physical Therapist | ||
N | 2251X0800X | Physical Therapist - Orthopedic | PT02055 | RI |
NPI | 1386654705 |
---|---|
Provider Name | Amy L. Vincent |
First Address | Wakefield, RI 02879-4334 |
Second Address | Wakefield, RI 02879-4334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 29/06/2020 |