Individual
MRS. STACY LYNN VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4232 29TH ST SE, GRAND RAPIDS, MI 49512-1936
(616) 942-1818
(616) 942-6567
Mailing address
4232 29TH ST SE, GRAND RAPIDS, MI 49512-1936
(616) 942-1818
(616) 942-6567
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3501003278
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3501003278
STATE OF MICHIGAN LICENSE
MI
Enumeration date
02/18/2016
Last updated
02/18/2016
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