Provider Demographics
NPI:1386654705
Name:VINCENT, AMY L (MSPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:VINCENT
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:24 SALT POND RD STE D4
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-4334
Mailing Address - Country:US
Mailing Address - Phone:401-667-4965
Mailing Address - Fax:401-667-7243
Practice Address - Street 1:24 SALT POND RD STE D4
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-4334
Practice Address - Country:US
Practice Address - Phone:401-667-4965
Practice Address - Fax:401-667-7243
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIPT020552081S0010X, 2251X0800X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic