Individual
DANIEL VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4623 ENTERPRISE WAY, CALDWELL, ID 83605-6764
(208) 455-4231
Mailing address
1141 E FAIRVIEW AVE APT M201, MERIDIAN, ID 83642-1837
(515) 249-8881
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA-7438
ID
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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