Individual
JONATHAN VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1112 W 6TH ST STE 124, LAWRENCE, KS 66044-2249
(785) 838-7885
Mailing address
1112 W 6TH ST STE 124, LAWRENCE, KS 66044-2249
(785) 838-7885
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00978
KS
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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