Organization
VINCENT PHYSICAL THERAPY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHEL VINCENT PT, MOMT (CEO, PRESIDENT)
(626) 449-4347
Entity
Organization
Contact information
Practice address
2700 E FOOTHILL BLVD STE 101, PASADENA, CA 91107-3443
(626) 449-4347
(626) 449-4317
Mailing address
2700 E FOOTHILL BLVD STE 101, PASADENA, CA 91107-3443
(626) 449-4347
(626) 449-4317
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ03532Z
BLUE SHIELD GROUP NUMBER
CA
Enumeration date
01/31/2006
Last updated
07/21/2022
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