Individual
JENNISON VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
285 BABCOCK ST, BOSTON, MA 02215-1003
(617) 696-7663
Mailing address
70 ALLSTON ST, ALLSTON, MA 02134-5001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1954
MA
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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