DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. RICHARD P VICENZI, ATHLETIC TRAINER

Active

Athletic Trainer · HERRIN, IL

Registration Details

NPI Number
1841447026
Provider Type
Individual
Gender
Male
NPI Issued
Aug 19, 2008 (17.674201577945 yrs)
Last Updated
Aug 19, 2008
License
096000258 (IL)

Practice Information

Address
510 LINCOLN DRIVE
HERRIN, IL, 62948
Browse IL providers · Browse ZIP 62948
Phone
6189976800
Fax
6189989635
Primary Specialty
Athletic Trainer
225500000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.