Individual
VINCENT ALAN FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
371 CABANA BLVD W APT 107, MOBILE, AL 36609-1610
(765) 719-1800
Mailing address
371 CABANA BLVD W APT 107, MOBILE, AL 36609-1610
(765) 719-1800
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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