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Individual

BRYAN SAMUEL VINSON PRESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
3100 W MARSHALL ST, RICHMOND, VA 23230-4706
(804) 342-5857
(804) 355-0408
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207948
VA
225100000X
Physical Therapist
24512
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245679281
MEDICAID QMB PROVIDER ID
VA
01
C05954
MEDICARE GROUP PTAN
VA
Enumeration date
06/24/2013
Last updated
05/04/2018
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