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Individual

DR. TRACY JO VINCENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
10000 W 75TH ST, SUITE 250, MERRIAM, KS 66204-2209
(913) 894-1910
(877) 913-1174
Mailing address
10000 W 75TH ST, SUITE 250, MERRIAM, KS 66204-2209
(913) 894-1910
(877) 913-1174

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P13567
NC
2251P0200X
Pediatric Physical Therapist
P13567
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7212990
NC
Enumeration date
03/02/2012
Last updated
01/29/2013
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