Individual
VINCENT MANZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1730 BENNETT VILLAGE DR, MARYVILLE, TN 37804-2100
(708) 625-5157
Mailing address
1730 BENNETT VILLAGE DR, MARYVILLE, TN 37804-2100
(708) 625-5157
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
5172
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
03/16/2022
Last updated
02/27/2026
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