Individual
VANESSA DENISE VINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 CITY AVE APT 12103, PHILA, PA 19131-1578
(240) 733-2039
Mailing address
4700 CITY AVE APT 12103, PHILA, PA 19131-1578
(240) 733-2039
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
02022019
PA
Other
Enumeration date
02/05/2021
Last updated
02/16/2021
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