Healthcare Provider Details

I. General information

NPI: 1043419419
Provider Name (Legal Business Name): VINCENT & LEE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 COOLIDGE SUITE 9
EAST LANSING MI
48823
US

IV. Provider business mailing address

2200 COOLIDGE SUITE 9
EAST LANSING MI
48823
US

V. Phone/Fax

Practice location:
  • Phone: 517-332-4164
  • Fax: 517-332-3745
Mailing address:
  • Phone: 517-332-4164
  • Fax: 517-332-3745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3501002201
License Number StateMI

VIII. Authorized Official

Name: MR. JAMES VINCENT CESPEDES
Title or Position: PRESIDENT
Credential:
Phone: 517-332-4164