Provider Demographics
NPI:1033453592
Name:VINET, VICTORIA JEAN (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:JEAN
Last Name:VINET
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 SAND CREEK DR STE C
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-1590
Mailing Address - Country:US
Mailing Address - Phone:219-926-9779
Mailing Address - Fax:219-926-9889
Practice Address - Street 1:425 SAND CREEK DR STE C
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-1590
Practice Address - Country:US
Practice Address - Phone:219-926-9779
Practice Address - Fax:219-926-9889
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1142701225100000X
IN05009684A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist