Individual
MR. VINCENT JON MENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1815 4TH ST, RADFORD, VA 24141-4317
(540) 230-5598
Mailing address
1815 4TH ST, RADFORD, VA 24141-4317
(540) 230-5598
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603384
VA
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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