Individual
SHANNAN C VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3016 PORTAGE AVE, SOUTH BEND, IN 46628-3501
(574) 272-9011
Mailing address
686 FOREST CT, NAPPANEE, IN 46550-2831
(574) 773-0207
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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