Provider Demographics
NPI:1912313669
Name:GANOE, VINCENT PATRICK (L AC)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:PATRICK
Last Name:GANOE
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
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Mailing Address - Street 1:1008 S 5TH AVE
Mailing Address - Street 2:CRICKLEWOOD CENTER, SUITE 102
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-8676
Mailing Address - Country:US
Mailing Address - Phone:814-226-6695
Mailing Address - Fax:814-226-7076
Practice Address - Street 1:1008 S 5TH AVE
Practice Address - Street 2:CRICKLEWOOD CENTER, SUITE 102
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-8676
Practice Address - Country:US
Practice Address - Phone:814-226-6695
Practice Address - Fax:814-226-7076
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAAK001111171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist