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Individual

CHARLES E ST. VINCENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
862 MEINECKE AVE, STE. 101, SAN LUIS OBISPO, CA 93405-1721
(805) 541-4717
(805) 541-4235
Mailing address
15 CHUPARROSA DR, SAN LUIS OBISPO, CA 93401-7411
(805) 541-4717
(805) 541-4235

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5452
CA

Other

Enumeration date
10/17/2006
Last updated
07/08/2007
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