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Individual

MR. VINCENT JOSEPH LEAVEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, ATC, PES, CSCS

Contact information

Practice address
406 MEMORIAL AVE, WESTMONT, NJ 08108-3398
(856) 869-7750
Mailing address
11 E 3RD AVE, PINE HILL, NJ 08021-6203
(856) 504-6819

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00132700
NJ

Other

Enumeration date
03/20/2007
Last updated
05/22/2010
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