Individual
SHELBY LYNNE VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
313 S 5TH ST, ODESSA, DE 19730-2078
(302) 376-4128
Mailing address
1418 S STATE ST, DOVER, DE 19901-4948
(302) 734-1515
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0001176
DE
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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