Provider Demographics
NPI:1154061133
Name:VINSON, TORI
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:
Last Name:VINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 TANQUERAY ST
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-1553
Mailing Address - Country:US
Mailing Address - Phone:678-633-0833
Mailing Address - Fax:
Practice Address - Street 1:275 HIGHWAY 74 N # 280
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1492
Practice Address - Country:US
Practice Address - Phone:678-528-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist