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General NPI Number Information
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NPI Number | 1730892118
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Entity Type | Individual
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Provider Name | ARSENIO VINCENT
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Gender | Male
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 1600 GORRELL ST
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City | GREENSBORO
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State | NC
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Zip | 27401-3525
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Country | US
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Telephone | 336-764-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 5704 W MARKET ST # 35531
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City | GREENSBORO
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State | NC
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Zip | 27419-0815
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Country | US
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Telephone | 336-764-7878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | 000032366518
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License Number State | NC
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