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NPI Code Detail

MEDICARE: MR. EDWIN PIERRE VINES MSPT

MEDICARE: MR. EDWIN PIERRE VINES MSPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 10042OH

General Provider Information

NPI Number : 1780892091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWIN PIERRE VINES MSPT
Provider Business Mailing Address
First Line : 1340 SHANABROOK DR
Second Line :
City : AKRON
State : OH
Zip : 44313-5734
Country : US
Telephone Number : 330-247-1194
Fax Number :
Provider Business Practice Location Address
First Line : 575 S CLEVELAND MASSILLON RD
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-3019
Country : US
Telephone Number : 330-666-5866
Fax Number : 330-666-3215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 11/04/2015

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