Individual
MS. HEATHER M VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4237 RIVER HILLS DR STE 150, LITTLE RIVER, SC 29566-6446
(843) 281-2778
(843) 281-2785
Mailing address
4237 RIVER HILLS DR STE 150, LITTLE RIVER, SC 29566-6446
(843) 281-2778
(843) 281-2785
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2605
SC
363A00000X
Physician Assistant
882
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004178
—
WV
Enumeration date
09/20/2006
Last updated
01/27/2022
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