Individual
REBECCA RUSSELL VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 GREENE STREET COLUMBIA, COLUMBIA, SC 29208-0001
(803) 777-7412
Mailing address
1601 GREENE ST, COLUMBIA, SC 29208-4001
(803) 429-1532
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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