Individual
JARED D VINC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, ATC
Contact information
Practice address
329 GREEN ST, BROCKTON, PA 17925-8835
(570) 617-6712
Mailing address
329 GREEN ST, BROCKTON, PA 17925-8835
(570) 617-6712
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE009382
PA
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
10/10/2006
Last updated
12/17/2013
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