Individual
MR. JOHN ANTHONY VINCENZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
694 OLD STAGE RD, ROGERSVILLE, TN 37857-6037
(423) 272-8431
Mailing address
694 OLD STAGE RD, ROGERSVILLE, TN 37857-6037
(423) 272-8431
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000072273
TN
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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